612例小儿术后自控静脉镇痛临床观察  

Clinical observation of postoperative patient-controlled intravenous analgesia in 612 children

作　　者：付月珍[1] 金泉英[1] 顾志清[1] 

机构地区：[1]上海交通大学附属上海市儿童医院麻醉科,上海市200040

出　　处：《实用诊断与治疗杂志》2007年第11期820-822,共3页Journal of Practical Diagnosis and Therapy

摘　　要：目的:总结小儿术后自控静脉镇痛的临床应用和术后镇痛过程中不良反应。方法:术后进行自控静脉镇痛的患儿612例。根据视觉模拟评分法、Ramsay改良分级法、自控镇痛按压次数进行镇痛镇静效果评定。观察并记录自控静脉镇痛过程中各项生命体征、48h内按压自控镇痛的次数、不良反应的发生情况并进行统计学处理。结果:根据视觉模拟评分,镇痛效果优良率达98.33%;无镇静过度情况发生;生命体征稳定。不良反应发生率为13.06%,幼儿恶心呕吐发生率明显低于其他两个年龄组患儿(P<0.01);联合麻醉的患儿恶心呕吐的发生率明显低于单纯全身麻醉的患儿(P<0.01);单纯局麻的患儿椎体外系症状的发生率高达11.48%,与单纯全麻的患儿相比差异有统计学意义(P<0.05)。结论:自控静脉镇痛用于小儿术后镇痛安全可靠,不良反应少,联合麻醉的术后镇痛不良反应发生率低于其他麻醉方法。　Objective To summarize the importance of the pediatric patient-controlled intravenous analgesia in clinical practice and to discuss the adverse reactions about the postoperative analgesia.Methods Six hundred and twelve postoperative patients received intravenous patient-controlled intravenous with fentanyl and droperidol.According to Visual Simulation Scoring Act,Ramesay improved classification scheme,the number of patient-controlled intravenous button for analgesic effect was used to assess the results.The patients＇life function indicators and the numbers of patient-controlled intravenous buttons were observed and recorded in 48 hours and the occurrence of adverse reactions for statistical processing.Results Analgesic effect was good.Analgesic effect of the fine rate was 98.33% by visual analog scale scores without excessive analgesia.Life function indicators were stable.The incidence of adverse reactions was low to 13.06%.The incidence of child nausea vomiting was significantly less than the other two age groups.The nausea vomiting incidence of combined anesthesia was significantly lower than that of simple general anesthesia（P〈0.01）.The incidence of other adverse reactions was significantly less than the other two methods of anesthesia（P〈0.05）.The extrapyramidal symptom incidence of simple regional anesthesia was high to 11.48% and significantly different from simple body anesthesia（P〈0.05）.Conclusion The analgesia disposed in patient-controlled intravenous analgesia is safe and reliable for children.Because the effect of analgesic is satisfactory,the life function indicators are stable and the adverse reactions are fewer.In addition,the incidence of child adverse reactions by combined anesthesia is lower than other anesthesias.

关 键 词：术后镇痛 小儿 自控静脉镇痛 芬太尼 氟哌啶 不良反应 

分 类 号：R726.1[医药卫生—儿科]