不同浓度罗哌卡因用于小儿髂筋膜腔隙阻滞的研究  

Effect of fascia illiaca compartment block (FICB) with ropivacaine on early analgesia in children with development dislocation of the hip (DDH) received salter arthroplasty treatment

作　　者：王晓林[1] 张大志[1] 王庚[1] 

机构地区：[1]北京积水潭医院麻醉科,100035

出　　处：《中华临床医师杂志（电子版）》2011年第9期2602-2605,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的观察不同浓度罗哌卡因髂筋膜腔隙阻滞(FICB)用于小儿发育性髋脱位(DDH)术后早期镇痛的效果和安全性。方法选取择期行单侧DDH手术的患儿80例,随机分为四组,每组20例。全身麻醉诱导后,四组均用罗哌卡因行患侧FICB:Ⅰ组用0.3%罗哌卡因;Ⅱ组用0.25%罗哌卡因;Ⅲ组用0.2%罗哌卡因;Ⅳ组用0.15%罗哌卡因。术中以静脉吸入复合维持麻醉,分别记录术中芬太尼用量,术后1h、4h和24h疼痛行为学评分以及患儿父母的满意度;同时记录不良反应发生情况。结果与Ⅳ组比较,Ⅰ组、Ⅱ组、Ⅲ组术中芬太尼用量显著减少,术后1h、4h和24h疼痛行为学评分显著降低,总体满意度显著提高。结论 0.2%罗哌卡因、0.25%罗哌卡因和0.3%罗哌卡因行FICB可用于小儿DDH手术后早期镇痛,效果确切、安全,实施方法简便易行。Objective To observe the effect and complication of fascia illiaca compartment block (FICB) to early analgesia of children with development dislocation of the hip (DDH) received Salter arthroplasty treatment.Methods 80 cases of children with DDH were divided into four groups randomly:group Ⅰ (FICB was used with ropivacaine 0.3%,1 ml/kg,maximum 30 ml),group Ⅱ (FICB was used with ropivacaine 0.25%,1 ml/kg,maximum 30 ml),group Ⅲ(FICB was used with ropivacaine 0.2%,1 ml/kg,maximum 30 ml) and group Ⅳ(FICB was used with ropivacaine 0.15%,1 ml/kg,maximum 30 ml).The consumption of fentanyl during surgery,CRIES pain score at 1 h,4 h and 24 h postoperatively,the satisfaction score of parents,side effects were recorded.Results Compare with group Ⅳ,the first three groups consumption of fentanyl during surgery were lower,pain scores at 1 h,4 h and 24 h postoperative were lower,the satisfaction score of parents was higher in groupⅠand groupⅡsignificantly.Conclusions The method of ropivacaine (0.2%-0.3%) used for FICB to early analgesia of children with DDH had the merits of safety,precise effect and convenient manipulation.

关 键 词：神经传导阻滞 髋脱位 先天性 镇痛 罗哌卡因 

分 类 号：R726.1[医药卫生—儿科]