中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2009年
11期
985-987
,共3页
镇痛%病人控制%儿童
鎮痛%病人控製%兒童
진통%병인공제%인동
Analgesia%patient-controlled%Children
目的 评价骨科下肢手术患儿术后父母控制静脉镇痛的效应.方法 择期行骨科下肢矫形手术患儿507例,ASA Ⅰ或Ⅱ级,年龄10月～8岁,8.5～34.0 kg.按年龄分为2组:<6岁的患儿采用父母控制静脉镇痛组(n=308);≥6岁的患儿采用自控静脉镇痛组(n=199).气管插管或喉罩全麻复合0.25%布比卡因骶管阻滞下进行手术,术后给予吗啡镇痛,背景输注速率15μg~(-1)·kg~(-1)·h,PCA量15μg/kg,锁定时间10 min.于术后4、24、48 h时,采用Wong-Baker面部表情评分法或改良面部表情评分法评价疼痛程度;采用Ramsay评分评价镇静程度.于术后24、48 h时记录PCA次数和吗啡剂量;记录术后48 h内不良反应的发生情况.结果 两组术后镇痛效果、镇静水平、PCA次数、吗啡剂量和不良反应发生率差异无统计学意义(P>0.05).结论 父母控制静脉镇痛可安全、有效地用于骨科下肢手术患儿术后镇痛.
目的 評價骨科下肢手術患兒術後父母控製靜脈鎮痛的效應.方法 擇期行骨科下肢矯形手術患兒507例,ASA Ⅰ或Ⅱ級,年齡10月～8歲,8.5～34.0 kg.按年齡分為2組:<6歲的患兒採用父母控製靜脈鎮痛組(n=308);≥6歲的患兒採用自控靜脈鎮痛組(n=199).氣管插管或喉罩全痳複閤0.25%佈比卡因骶管阻滯下進行手術,術後給予嗎啡鎮痛,揹景輸註速率15μg~(-1)·kg~(-1)·h,PCA量15μg/kg,鎖定時間10 min.于術後4、24、48 h時,採用Wong-Baker麵部錶情評分法或改良麵部錶情評分法評價疼痛程度;採用Ramsay評分評價鎮靜程度.于術後24、48 h時記錄PCA次數和嗎啡劑量;記錄術後48 h內不良反應的髮生情況.結果 兩組術後鎮痛效果、鎮靜水平、PCA次數、嗎啡劑量和不良反應髮生率差異無統計學意義(P>0.05).結論 父母控製靜脈鎮痛可安全、有效地用于骨科下肢手術患兒術後鎮痛.
목적 평개골과하지수술환인술후부모공제정맥진통적효응.방법 택기행골과하지교형수술환인507례,ASA Ⅰ혹Ⅱ급,년령10월～8세,8.5～34.0 kg.안년령분위2조:<6세적환인채용부모공제정맥진통조(n=308);≥6세적환인채용자공정맥진통조(n=199).기관삽관혹후조전마복합0.25%포비잡인저관조체하진행수술,술후급여마배진통,배경수주속솔15μg~(-1)·kg~(-1)·h,PCA량15μg/kg,쇄정시간10 min.우술후4、24、48 h시,채용Wong-Baker면부표정평분법혹개량면부표정평분법평개동통정도;채용Ramsay평분평개진정정도.우술후24、48 h시기록PCA차수화마배제량;기록술후48 h내불량반응적발생정황.결과 량조술후진통효과、진정수평、PCA차수、마배제량화불량반응발생솔차이무통계학의의(P>0.05).결론 부모공제정맥진통가안전、유효지용우골과하지수술환인술후진통.
Objective To evaluate the efficacy and safety of parent-controlled analgesia for postoperative pain management in pediatric patients. Methods Five hundred and seven ASA Ⅰ or Ⅱ pediatric patients aged 10 months to 8 yr, weighting 8.5-34.0 kg, undergoing lower limb operations performed under general anesthesia combined with caudal block were assigned into 2 age groups: group PCIA-P ( < 6 yr, n = 308) and group PCIA ( ≥6yr, n = 199). Anesthesia was induced with intravenous midazolam 1 mg/kg, ketamine 2 mg/kg and propofol 2 mg/kg. Laryngeal mask airway (LMA) was introduced or the patients were intubated. After induction, caudal block was performed with 0.25% bupivacaine 2.5 mg/kg with adrenaline 1:400 000. The patients received PCA with morphine after operation. The PCA pump was controlled by parent in group PCIA-P and by patient in group PCIA. The PCA regimen included a background infusion of morphine at a rate of 15μg~(-1)·kg~(-1)·h, a bolus of 15μg/kg and a 10 min lockout interval. The vital signs, pain score, sedation score, number of attempts, morphine dosage and side effects were recorded. Results The two groups were comparable with respect to the rate of satisfactory analgesia, level of sedation, number of attempts, morphine dosage and side effects. The rates of satisfactory analgesia were 72.7% and 80.2% in group PCIA-P vs 77.9% and 78.9% in group PCIA at 24 and 48 h after operation respectively ( P > 0.05) . Conclusion Parent-controlled analgesia could be used safely and effectively in children after orthopedic surgery.
