CAJ | 학술논문

目的：评价右美托咪定混合利多卡因骶管阻滞用于小儿围术期镇痛管理的效果。方法拟行单侧疝囊高位结扎术的患儿30例，年龄2～6岁，体重8～23 kg，采用随机数字表法分为利多卡因组（ L组）和右美托咪定混合利多卡因组（ DL组），每组15例。 L组骶管注射1％利多卡因1 ml∕kg，DL组骶管注射1％利多卡因1 ml∕kg混合右美托咪定1μg∕kg。 FLACC评分≥4分时口服布洛芬混悬液10 mg∕kg。记录术后8 h内布洛芬使用情况，记录骶管阻滞起效时间和镇痛持续时间，观察不良反应的发生情况。结果与L组比较，DL组患儿骶管阻滞起效时间缩短，镇痛持续时间延长，布洛芬使用率降低（ P＜0．05）；两组不良反应的发生率比较差异无统计学意义（ P＞0．05）。结论骶管注射右美托咪定1μg∕kg可显著优化单纯利多卡因骶管阻滞用于小儿围术期镇痛管理的效果。
목적：평개우미탁미정혼합리다잡인저관조체용우소인위술기진통관리적효과。방법의행단측산낭고위결찰술적환인30례，년령2～6세，체중8～23 kg，채용수궤수자표법분위리다잡인조（ L조）화우미탁미정혼합리다잡인조（ DL조），매조15례。 L조저관주사1％리다잡인1 ml∕kg，DL조저관주사1％리다잡인1 ml∕kg혼합우미탁미정1μg∕kg。 FLACC평분≥4분시구복포락분혼현액10 mg∕kg。기록술후8 h내포락분사용정황，기록저관조체기효시간화진통지속시간，관찰불량반응적발생정황。결과여L조비교，DL조환인저관조체기효시간축단，진통지속시간연장，포락분사용솔강저（ P＜0．05）；량조불량반응적발생솔비교차이무통계학의의（ P＞0．05）。결론저관주사우미탁미정1μg∕kg가현저우화단순리다잡인저관조체용우소인위술기진통관리적효과。
Objective To evaluate the efficacy of caudal block with dexmedetomidine mixed with lidocaine for management of perioperative analgesia in children. Methods Thirty pediatric patients, aged 2-6 yr, weighing 8-23 kg, scheduled for elective unilateral high ligation of hernial sac, were equally and randomly assigned into either lidocaine group ( group L ) or dexmedetomidine mixed with lidocaine group ( group DL) using a random number table. Each patient received a single caudal dose of 1% lidocaine 1 ml∕kg in group L. Each patient received a single caudal dose of 1% lidocaine 1 ml∕kg mixed with dexmedetomidine 1 μg∕kg in group DL. Postoperative analgesia was assessed using FLACC scale. When FLACC score ≥4, ibuprofen suspension 10 mg∕kg was given orally. The consumption of ibuprofen was recorded within 8 h after operation. The onset time of caudal block and duration of analgesia were recorded, and adverse effects were observed. Results Compared with group L, the onset time of caudal block was significantly shortened, the duration of analgesia was prolonged, and the requirement for ibuprofen was decreased in group L. There was no significant difference in adverse effects between the two groups. Conclusion Addition of dexmedetomidine 1 μg∕kg to caudal lidocaine can significantly optimize the efficacy of caudal block with lidocaine alone for the management of perioperative analgesia in children.