芬太尼与曲马多复合罗哌卡因骶管注入用于小儿术后镇痛的临床比较  

Clinical comparison of caudal fentanyl and tramal combined with ropivacaine for postoperative analgesia in pediatrics

作　　者：高琳琳[1] 董有静[1] 李国福[1] 

机构地区：[1]中国医科大学附属盛京医院,沈阳110004

出　　处：《实用药物与临床》2012年第7期396-398,共3页Practical Pharmacy and Clinical Remedies

摘　　要：目的比较芬太尼和曲马多复合利多卡因和罗哌卡因骶管注入用于小儿术后镇痛的效果及安全性。方法 90例择期行下腹部手术的患儿随机分为3组,每组30例。0.7%利多卡因+0.25%罗哌卡因(A组)、0.7%利多卡因+0.25%罗哌卡因+芬太尼2μg/kg(B组)和0.7%利多卡因+0.25%罗哌卡因+曲马多1 mg/kg(C组)。结果用OPS法及Ramsay法分别进行镇痛及镇静评分并随访副作用的发生率。术后12 h、24h OPS<4分的百分率B和C组明显高于A组(P<0.05),B和C组在术后24 h时亦有显著性差异(P<0.05)。镇静评分B和C组在术后6 h内各时点明显高于A组(P<0.05)。皮肤瘙痒、恶心呕吐发生率B组明显高于A组和C组(P<0.05),B和C组术后精神方面不良反应发生率低于A组(P<0.05)。结论曲马多复合利多卡因和罗哌卡因骶管注入镇痛效果较好,且不良反应较少,优于芬太尼。Objective To compare the efficacy and side effects of fentanyl and tramal combined with lidocaine and ropivacaine injected for caudal analgesia in pediatrics. Methods 90 children undergoing elective lower abdominal surgery were randomly allocated to 3 groups to receive a caudal injection（ n = 30）. Group A ：0. 7% lidocaine ＋ 0. 25% ropivacaine, group B：0. 7% lidocaine ＋ 0. 25 % ropivacaine ＋ 2 μg/kg fentanyl, group C：0. 7% lidocaine ＋ 0. 25 % ropivacaine ＋ 1 mg/kg tramal： Results Postoperative pain （OPS method）/sedation （Ramsay method）score and inci- dence of side effects were assessed after operation. The percentage of OPS 〈 4 in group B and C was obviously more than that in group A 12 h,24 h after operation（P 〈0. 05）. There was significant difference about the percentage of OPS 〈4 between group B and group C 24 h after operation（P 〈0. 05）. The sedation scores were higher in group B and C within 6 h（ P 〈 0. 05 ）. The incidences of postoperative itching, nausea and vomiting in group B were higher than those in group A and C （ P 〈 0. 05 ）. The incidences of psychic side effects in group B and C were lower than those in group A （ P 〈 0.05 ）. Conclusion Tramal combined with lidocaine and ropivacaine caudal injection may be safe and effective to achieve satisfactory postoperative analgesia compared with fentanyl in children.

关 键 词：芬太尼 曲马多 骶管阻滞 术后镇痛 

分 类 号：R726.1[医药卫生—儿科]