髂筋膜间隙阻滞用于小儿发育性髋脱位术后的早期镇痛  

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

作　　者：王庚[1] 王晓林[1] 李世忠[1] 

机构地区：[1]北京积水潭医院麻醉科,100035

出　　处：《中华医学杂志》2011年第37期2638-2640,共3页National Medical Journal of China

摘　　要：目的观察髂筋膜间隙阻滞用于小儿发育性髋脱位术后早期镇痛的效果和安全性。方法选取2010年4月至10月北京积水潭医院择期行单侧发育性髋脱位手术的患儿64例，经医院伦理委员会通过，随机数字表随机分为神经阻滞组（F组）和对照组（C组）。全身麻醉诱导后，F组用0．2％罗哌卡因行患侧髂筋膜间隙阻滞；C组用生理盐水行患侧髂筋膜间隙阻滞。术中以静吸复合维持麻醉，分别记录术中及术后恢复室芬太尼用量，术后1、4、24h疼痛行为学评分，患儿家长满意度，以及不良反应发生情况。结果与C组比较，F组术中芬太尼用量显著减少[（66±21）ug减至（51±13）ug，P〈0．05]，术后1、4、24h疼痛行为学评分显著降低（分别为2．3±0．8，2．0±0．6，1．2±0．4，P〈0．05），家长满意度显著提高（3．4±0．6升至4．9±0．3，P〈0．05），不良反应差异无统计学意义。结论0．2％罗哌卡因行单次髂筋膜间隙阻滞用于小儿发育性髋脱位手术后早期镇痛，安全性好，镇痛效果确切持久，实施方法简便易行。Objective To observe the efficacy and safety of fascia illiaca compartment block （FICB） with 0. 2% ropivacaine in the early analgesia of children with development dislocation of the hip （DDH） undergoing Salter arthroplasty. Methods Approved by the hospital ethics committee, a total of 64 DDH children were divided randomly into 2 groups： group F （FICB with ropivacaine 0. 2% , 1 mL/kg, max. 30 ml） and group C （FICB with 0. 9% normal saline 1 ml/kg, max. 30 ml）. The intra-operative doses of fentanyl, PACU （post-anesthesia care unit）, CRIES pain score at 1, 4 and 24 h postoperatively, patient satisfaction score and side effects were recorded. Results The intra-operative doses of fentanyl and PACU were lower. Pain scores at 1, 4 and 24 h postoperatively were lower. And the patient satisfaction score was significantly higher in the FICB group. Conclusion The administration of ropivacaine （0. 2% ） for FICB in the early analgesia of DDH children has the advantages of safety, precision, long-lasting and convenience.

关 键 词：髋脱位 先天性 麻醉药 局部 镇痛 罗哌卡因 

分 类 号：R726[医药卫生—儿科]