多模式鎮(zhèn)痛在患兒先天性髖關(guān)節(jié)脫位矯正術(shù)快速康復(fù)中的應(yīng)用
發(fā)布時(shí)間：2018-10-18 13:41
【摘要】：目的觀察基于快速康復(fù)外科理念的多模式鎮(zhèn)痛在患兒先天性髖關(guān)節(jié)脫位手術(shù)治療中的應(yīng)用。方法擇期行髖關(guān)節(jié)脫位手術(shù)患兒90例,年齡1~7歲,隨機(jī)分為三組,每組30例。A組采用靜-吸復(fù)合全麻;B組采用靜-吸復(fù)合全麻復(fù)合骶管阻滯,即麻醉誘導(dǎo)后骶管注射0.25%羅哌卡因1ml/kg;C組在B組的基礎(chǔ)上于手術(shù)前15min肛塞對(duì)乙酰氨基酚30~35mg/kg。三組患兒術(shù)后均采用舒芬太尼靜脈自控鎮(zhèn)痛(PCIA)。分別記錄患兒術(shù)后蘇醒即刻(T1)、4h(T2)、8h(T3)、12h(T4)、24h(T5)、36h(T6)、48h(T7)的FLACC疼痛評(píng)分和Ramsay鎮(zhèn)靜評(píng)分,以及蘇醒即刻PAED躁動(dòng)評(píng)分。結(jié)果與A組比較,B組和C組T1~T6時(shí)FLACC評(píng)分明顯降低,T1、T2時(shí)Ramsay評(píng)分明顯升高,T1時(shí)PAED評(píng)分明顯降低(P0.05);T7時(shí)C組FLACC評(píng)分明顯降低(P0.05)。與B組比較,T4、T5、T7時(shí)C組FLACC評(píng)分明顯降低(P0.05)。結(jié)論骶管阻滯、肛塞對(duì)乙酰氨基酚聯(lián)合PCIA用于患兒先天性髖關(guān)節(jié)脫位矯正術(shù)可增強(qiáng)術(shù)后鎮(zhèn)痛效果,減少蘇醒期躁動(dòng)的發(fā)生,利于快速康復(fù)。
[Abstract]:Objective to observe the application of multi-mode analgesia based on rapid rehabilitation surgery in the surgical treatment of congenital dislocation of hip in children. Methods 90 children with hip dislocation, aged 1 to 7 years, were randomly divided into three groups, 30 cases in each group. That is, after anesthesia induction, 0.25% ropivacaine was injected into the sacral canal of group C on the basis of group B, and paracetamol 30 mg / kg / kg of acetaminophen was inserted into the anus of group B before operation. Sufentanil for patient-controlled analgesia (PCIA).) was used in all three groups after operation. FLACC pain scores and Ramsay sedation scores were recorded immediately after recovery (T1), 4h (T2), 8h (T3), 12h (T4), 24h (T5), 36h (T6), 48h (T7), and PAED restlessness. Results compared with group A, FLACC score of group B and group C decreased significantly at T1~T6, Ramsay score of group T _ 1 and T _ 2 increased significantly, PAED score of group T _ 1 decreased significantly (P 0.05), FLACC score of group C decreased significantly at group T _ 7 (P0.05). Compared with group B, the FLACC score of group C was significantly lower than that of group B (P 0.05). Conclusion sacral canal block, anus paracetamol combined with PCIA can enhance postoperative analgesia, reduce restlessness during recovery, and facilitate rapid recovery in children with congenital dislocation of hip.
【作者單位】： 安徽醫(yī)科大學(xué)第一附屬醫(yī)院麻醉科;安徽省兒童醫(yī)院麻醉科;
【分類號(hào)】：R726.1
本文編號(hào)：2279297
[Abstract]:Objective to observe the application of multi-mode analgesia based on rapid rehabilitation surgery in the surgical treatment of congenital dislocation of hip in children. Methods 90 children with hip dislocation, aged 1 to 7 years, were randomly divided into three groups, 30 cases in each group. That is, after anesthesia induction, 0.25% ropivacaine was injected into the sacral canal of group C on the basis of group B, and paracetamol 30 mg / kg / kg of acetaminophen was inserted into the anus of group B before operation. Sufentanil for patient-controlled analgesia (PCIA).) was used in all three groups after operation. FLACC pain scores and Ramsay sedation scores were recorded immediately after recovery (T1), 4h (T2), 8h (T3), 12h (T4), 24h (T5), 36h (T6), 48h (T7), and PAED restlessness. Results compared with group A, FLACC score of group B and group C decreased significantly at T1~T6, Ramsay score of group T _ 1 and T _ 2 increased significantly, PAED score of group T _ 1 decreased significantly (P 0.05), FLACC score of group C decreased significantly at group T _ 7 (P0.05). Compared with group B, the FLACC score of group C was significantly lower than that of group B (P 0.05). Conclusion sacral canal block, anus paracetamol combined with PCIA can enhance postoperative analgesia, reduce restlessness during recovery, and facilitate rapid recovery in children with congenital dislocation of hip.
【作者單位】： 安徽醫(yī)科大學(xué)第一附屬醫(yī)院麻醉科;安徽省兒童醫(yī)院麻醉科;
【分類號(hào)】：R726.1
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