中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2013年
10期
1206-1208
,共3页
酰胺类%麻醉,局部%扁桃体切除术%疼痛,手术后%儿童
酰胺類%痳醉,跼部%扁桃體切除術%疼痛,手術後%兒童
선알류%마취,국부%편도체절제술%동통,수술후%인동
Amides%Anesthesia,local%Tonsillectomy%Pain,postoperative%Child
目的 比较不同浓度罗哌卡因局部浸润用于患儿扁桃体切除术后镇痛的效果.方法 择期拟行扁桃体切除术患儿60例,ASA分级Ⅰ级,年龄6～ 12岁,性别不限,体重18 ～ 41 kg,采用随机数字表法分为3组(n=20):对照组(C组)、0.2％罗哌卡因组(R1组)和0.5％罗哌卡因组(R2组).术前于扁桃体周围行局部浸润注射,手术在全麻下进行.R1组和R2组分别注射0.2％和0.5％罗哌卡因,每侧3～5 ml,C组不予任何处理.术后1、3、6、12和24 h时采用修订版面部表情疼痛量表(FPS-R)评价疼痛程度,术后FPS-R评分≥4分时口服扑热息痛5 mg/kg.记录清醒气管拔管至首次使用镇痛药物时间间隔、术后镇痛药物使用情况及不良反应发生情况.结果 与C组比较,R1组和R2组清醒气管拔管至首次使用镇痛药物时间间隔延长,镇痛药物使用率减少(P＜0.05);与R1组比较,R2组清醒拔管至首次使用镇痛药物时间间隔延长、镇痛药物使用率减少(P＜0.05);两组不良反应发生率比较差异无统计学意义(P＞0.05).结论 罗哌卡因局部浸润用于患儿扁桃体切除术后镇痛的适宜浓度为0.5％.
目的 比較不同濃度囉哌卡因跼部浸潤用于患兒扁桃體切除術後鎮痛的效果.方法 擇期擬行扁桃體切除術患兒60例,ASA分級Ⅰ級,年齡6～ 12歲,性彆不限,體重18 ～ 41 kg,採用隨機數字錶法分為3組(n=20):對照組(C組)、0.2％囉哌卡因組(R1組)和0.5％囉哌卡因組(R2組).術前于扁桃體週圍行跼部浸潤註射,手術在全痳下進行.R1組和R2組分彆註射0.2％和0.5％囉哌卡因,每側3～5 ml,C組不予任何處理.術後1、3、6、12和24 h時採用脩訂版麵部錶情疼痛量錶(FPS-R)評價疼痛程度,術後FPS-R評分≥4分時口服撲熱息痛5 mg/kg.記錄清醒氣管拔管至首次使用鎮痛藥物時間間隔、術後鎮痛藥物使用情況及不良反應髮生情況.結果 與C組比較,R1組和R2組清醒氣管拔管至首次使用鎮痛藥物時間間隔延長,鎮痛藥物使用率減少(P＜0.05);與R1組比較,R2組清醒拔管至首次使用鎮痛藥物時間間隔延長、鎮痛藥物使用率減少(P＜0.05);兩組不良反應髮生率比較差異無統計學意義(P＞0.05).結論 囉哌卡因跼部浸潤用于患兒扁桃體切除術後鎮痛的適宜濃度為0.5％.
목적 비교불동농도라고잡인국부침윤용우환인편도체절제술후진통적효과.방법 택기의행편도체절제술환인60례,ASA분급Ⅰ급,년령6～ 12세,성별불한,체중18 ～ 41 kg,채용수궤수자표법분위3조(n=20):대조조(C조)、0.2％라고잡인조(R1조)화0.5％라고잡인조(R2조).술전우편도체주위행국부침윤주사,수술재전마하진행.R1조화R2조분별주사0.2％화0.5％라고잡인,매측3～5 ml,C조불여임하처리.술후1、3、6、12화24 h시채용수정판면부표정동통량표(FPS-R)평개동통정도,술후FPS-R평분≥4분시구복복열식통5 mg/kg.기록청성기관발관지수차사용진통약물시간간격、술후진통약물사용정황급불량반응발생정황.결과 여C조비교,R1조화R2조청성기관발관지수차사용진통약물시간간격연장,진통약물사용솔감소(P＜0.05);여R1조비교,R2조청성발관지수차사용진통약물시간간격연장、진통약물사용솔감소(P＜0.05);량조불량반응발생솔비교차이무통계학의의(P＞0.05).결론 라고잡인국부침윤용우환인편도체절제술후진통적괄의농도위0.5％.
Objective To compare local infiltration anesthesia with different concentrations of ropivacaine for postoperative analgesia in pediatric patients undergoing tonsillectomy.Methods Sixty ASA physical status Ⅰ patients of both sexes,aged 6-12 yr,weighing 18-41 kg,scheduled for elective tonsillectomy,were randomly divided into 3 groups (n =20 each) using a random number table:control group (group C); 0.2％ ropivacaine group (group R1) ; 0.5 ％ ropivacaine group (group R2).Anesthesia was induced with inhalation of sevoflurane,injection of sufentanil and cisatracurium and maintained with inhalation of sevoflurane and iv infusion of remifentanil.The tonsil was locally infiltrated vith 0.2 ％ and 0.5％ ropivacaine (3-5 ml on each side of the tonsil) before surgery in R1 and R2 groups,respectively.Tonsillectomy was performed under general anesthesia.At 1,3,6,12,and 24 h after surgery,pain was assessed using faces pain scale-revised (FPS-R).Paracetamol 5 mg/kg was used as rescue analgesic when FPS-R scores ≥4.The interval between awake extubation and the first request for analgesic,requirement for postoperative analgesic and development of adverse effects were recorded.Results Compared with group C,the interval between awake extubation and the first request for analgesic was significantly prolonged,and the requirement for postoperative analgesic was decreased in R1 and R2 groups (P ＜ 0.05).Compared with group R1,the interval between awake extubation and the first request for analgesic was significantly prolonged,and the requirement for postoperative analgesic was decreased in R2 group (P ＜ 0.05).There was no significant difference in the incidence of adverse effects between the two groups (P ＞ 0.05).Conclusion The optinum concentration of locally infiltrated ropivacaine is 0.5 ％ for postoperative analgesia in pediatric patients undergoing tonsillectomy.
