舒芬太尼与利多卡因复合罗哌卡因骶管注入用于小儿尿道术后镇痛的临床比较  

Clinical comparison of postoperative analgesia of caudal injection of sufentanil or lidocaine combined with ropivacaine in children hypospadias repair

作　　者：蒋蓉娟[1] 谢先丰[1] 

机构地区：[1]成都市第二人民医院麻醉科,四川成都610017

出　　处：《实用医院临床杂志》2014年第5期128-130,共3页Practical Journal of Clinical Medicine

摘　　要：目的比较舒芬太尼与利多卡因分别复合罗哌卡因经骶管注入用于小儿尿道术后镇痛的临床效果。方法 60例择期行尿道下裂尿道成形术的患儿采用随机数字表法分为3组,每组20例。分别经骶管注入0.2%罗哌卡因1 ml/kg(R组)、0.8%利多卡因+0.2%罗哌卡因1 ml/kg(L组)和舒芬太尼0.5μg/ml+0.2%罗哌卡因1 ml/kg(S组)。术后0、1、2、4、6、8、12、24 h分别用改良CHEOPS和Bromega进行评分,并记录不良反应。结果所有患儿未观察到局麻药中毒反应。S组4 h后各时点CHEOPS评分均低于L组和R组(P<0.05)。术后6小时所有患儿运动功能完全恢复(Bromage评分>1分,P>0.05),在观察期均未出现不良反应。结论舒芬太尼复合罗哌卡因骶管注入用于小儿尿道术后镇痛安全有效,镇痛效果好。Objective To compare the clinical effect of postoperative analgesia of caudal injection of sufentanil or lidocaine combined with ropivacaine in children hypospadias repair .Methods Sixty children undergoing hypospadias repair were randomly di-vided into 3 groups,20 in each group.They receive a caudal injection with 0.2%ropivacaine （1 ml/kg） （group R）,0.8%lidocaine plus 0.2%ropivacaine （1 ml/kg） （group L） and 0.5μg/ml of sufentanil plus 0.2%ropivacaine （1 ml/kg） （group S）,respectively. The clinical effects after 0,1,2,4,6,8,12 and 24 h of surgery were assessed by using an improved CHEOPS score and Bromega meth-od,respectively .The side effects were recorded as well .Results No local anesthetics toxic reaction was observed in all children .The CHEOPS scores after 4 hours of surgery in the group S were lower than that in the groups L and R （ P〈0.05 ） .The motor functions were completely recovered after 6 hours of surgery in all children （Bromega score 〉1）.No adverse reaction occurred during the period of observation.Conclusion The caudal injection of sufentanil combined with ropivacaine may be safe and effective to achieve satisfac -tory postoperative analgesia in children .

关 键 词：舒芬太尼 罗哌卡因 骶管麻醉 术后镇痛 

分 类 号：R614.4[医药卫生—麻醉学]