CAJ | 학술논문

目的评价右美托咪定混合罗哌卡因骶管阻滞用于小儿围术期镇痛管理的效果.方法择期拟行尿道下裂手术患儿60例,年龄1～5岁,ASA分级Ⅰ或Ⅱ级.采用随机数字表法,将其分为2组(n=30):罗哌卡因组(R组)和右美托咪定混合罗哌卡因组(DR组).R组骶管注射0.25％罗哌卡因1 ml/kg;DR组骶管注射0.25％罗哌卡因1 ml/kg与右美托咪定2μg/kg混合液.于术后24 h内采用FLACC评分法评价镇痛效果,采用改良Bromage评分法评价运动阻滞程度,记录镇痛时间(骶管阻滞起效至术后首次使用补救镇痛药物的时间)及不良反应发生情况.结果与R组比较,DR组镇痛时间明显延长,心动过缓及过度镇静发生率明显升高(P＜0.05),而两组均未见低氧血症、低血压、术后运动阻滞发生.结论骶管注射右美托咪定2 μg/kg可显著优化单纯罗哌卡因骶管阻滞用于小儿围术期镇痛管理的效果.
목적 평개우미탁미정혼합라고잡인저관조체용우소인위술기진통관리적효과.방법 택기의행뇨도하렬수술환인60례,년령1～5세,ASA분급Ⅰ혹Ⅱ급.채용수궤수자표법,장기분위2조(n=30):라고잡인조(R조)화우미탁미정혼합라고잡인조(DR조).R조저관주사0.25％라고잡인1 ml/kg;DR조저관주사0.25％라고잡인1 ml/kg여우미탁미정2μg/kg혼합액.우술후24 h내채용FLACC평분법평개진통효과,채용개량Bromage평분법평개운동조체정도,기록진통시간(저관조체기효지술후수차사용보구진통약물적시간)급불량반응발생정황.결과 여R조비교,DR조진통시간명현연장,심동과완급과도진정발생솔명현승고(P＜0.05),이량조균미견저양혈증、저혈압、술후운동조체발생.결론 저관주사우미탁미정2 μg/kg가현저우화단순라고잡인저관조체용우소인위술기진통관리적효과.
Objective To evaluate the efficacy of caudal block with dexmedetomidine mixed with ropivacaine for the management of perioperative analgesia in children.Methods Sixty pediatric patients,aged 1-5 yr,of ASA physical status Ⅰ or Ⅱ,scheduled for elective hypospadias repair,were equally and randomly assigned into 2 groups using a random number table:ropivacaine group (group R) and dexmedetomidine mixed with ropivacaine group (group DR).Each patient received a single caudal dose of 0.25％ ropivacaine 1 ml/kg in group R.Each patient received a single caudal dose of 0.25％ ropivacaine 1 ml/kg mixed with dexmedetomidine 2 μg/kg in group DR.Postoperative analgesia was assessed using FLACC scale,and the degree of motor block was assessed using modified Bromage scale within 24 h after the end of operation.The duration of analgesia (the time from onset of caudal block to first requirement for the rescue analgesic) and development of side effects were recorded.Results Compared with group R,the duration of analgesia was significantly prolonged,and the incidence of bradycardia and oversedation was increased in group DR.Hypoxemia,hypotension and postoperative motor block were not found in either group.Conclusion Addition of dexmedetomidine 2 μg/kg to caudal ropivacaine can significantly optimize the efficacy of caudal block with ropivacaine alone for the management of perioperative analgesia in children.