小儿扁桃体腺样体切除术前局部注射曲马多的疗效  

The effects of peritonsillar injected tramadol before child adenotonsillectomy

作　　者：陈宏礼[1] 李建军[1] 张立强[2] 王秀钰[1] 

机构地区：[1]山东大学齐鲁医院第一麻醉科,济南250012 [2]山东大学齐鲁医院耳鼻咽喉科,济南250012

出　　处：《新医学》2013年第2期115-118,共4页Journal of New Medicine

摘　　要：目的:观察小儿扁桃体腺样体切除术前局部注射曲马多的术后镇痛效果及不良反应。方法:择期行扁桃体腺样体切除术的患儿72例,随机分为曲马多局部注射组和静脉注射组各36例。术前5 min,局部注射组双侧扁桃体窝局部注射、静脉注射组静脉注射曲马多2 mg/kg。记录术后自主呼吸恢复时间、拔除气管插管时间,拔管后即刻、2、6、12和24 h时的FPS-R疼痛评分,拔管后即刻、30 min、1 h时的镇静程度评分,24 h内追加镇痛药及不良反应发生情况。结果:两组患儿术后自主呼吸恢复时间、拔管时间、术后镇静程度无明显差异(P>0.05);局部注射组术后6 h时的疼痛评分、24 h内追加镇痛药的例数、恶心呕吐发生率明显较静脉注射组低(P<0.05)。结论:与静脉注射相比,小儿扁桃体腺样体切除术前局部注射曲马多可提供更有效的术后镇痛,且不良反应少。Objective： To assess the postoperative analgesic efficacy and side effects of peritonsillar injection with tramadol before surgery in children undergoing adenotonsillectomy. Methods： Seventy-two children undergoing selective adenotonsillectomy were randomized into two groups： peritonsillar injection group （peri group, n = 36 ） and intravenous injection group （ iv group, n = 36）. 5 min before the operation, peri group received 2 mg/kg tram- adol via peritonsillar injection, iv group received 2 mg/kg tramadol intravenously. Here were our observation inde- xes ： recovery of spontenous breath and extubation time ; FPS-R pain score at 0 min, 2 h, 6 h, 12 h, 24 h after ex- tubation ; sedation score at 0 rain, 30 rains, 1 h after the extubation ; rescue analgesia and side effects within 24 h. Results： No significant difference for the recovery of spontenous breath, extubation time and sedation scale （P 〉 0.05 ）. Peri group had a lower pain score at 6 h after the extubation compared with iv group, fewer cases need paracetamol and fewer cases had nausea and vomiting （ P 〈 0. 05 ）. Conclusion ： Comparing with intravenous in- jection, peritonsillar injection with tramadol before surgery can improve postoperative analgesia with fewer side effects in child adenotonsillectmy.

关 键 词：扁桃体腺样体切除 曲马多 扁桃体窝注射 超前镇痛 

分 类 号：R726.1[医药卫生—儿科]