硫酸镁联合罗哌卡因在小儿骶管阻滞中的应用  

Application of magnesium sulfate combined with ropivacaine in the treatment of caudal block in children

作　　者：张龙成 成龙 黄元庆 施鑫 许楷苓 

机构地区：[1]四川省巴中市中医医院麻醉科,四川巴中636000

出　　处：《实用药物与临床》2015年第6期736-739,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的探讨硫酸镁联合罗哌卡因在小儿骶管阻滞中运用的有效性和安全性。方法将59例接受单侧腹股沟疝修补术的患儿随机分为罗哌卡因组(R组)和硫酸镁罗哌卡因组(RM组),R组患儿于全麻成功后用0.15%罗哌卡因1 m L/kg行骶管阻滞,RM组患儿在全麻后以0.15%罗哌卡因1 m L/kg联合硫酸镁50 mg行骶管阻滞。比较两组患者FLACC评分、MBS评分、AS评分及术后1周的FAS评分,同时比较患儿术后止痛药物使用情况及术后不良反应发生情况。结果两组患儿一般情况比较差异无统计学意义,术后不同时间点FLACC评分、AS评分比较,RM组均低于R组,差异有统计学意义(P<0.05)。两组术后M BS评分、术后不良反应比较差异无统计学意义(P>0.05)。R组患儿术后镇痛药物芬太尼及对乙酰氨基酚的用量均大于RM组,差异有统计学意义(P<0.05)。两组术后1周FAS评分均为0。结论 50 mg硫酸镁联合罗哌卡因小儿骶管阻滞较单纯罗哌卡因能提供更好的术后镇痛效果。Objective To investigate the efficacy and safety of magnesium sulfate combined with ropivacaine in the treatment of caudal analgesia in children. Methods Fifty nine children underwent inguinal herniorrhaphy were divided into two groups randomly. For caudal block,group R received ropivacaine 1. 5 mg / m L,1 m L / kg,group RM received the same dose of ropivacaine mixed with 50 mg of magnesium sulfate. The patients＇ face,legs,activity,cry,consolability（ FLACC） score,modified bromage score（ M BS）,Aono＇s score（ AS） and functional activity score（ FAS） were compared. At the same time,the analgesic consumption and adverse effects were recorded. Results After operation,the FLACC score and AS score in group RM were significantly lower than those of group R（ P〈0. 05）,and there was no significant difference in M BS score and adverse effects between the two groups（ P〈0. 05）. Children in group RM required less fentanyl and acetaminophen for rescue analgesia in the recovery（ P〈0. 05）. The FAS score at a week after operation of patients was 0. Conclusion As an adjuvant for caudal analgesia,50 mg magnesium provides superior quality of analgesia than local anesthetic alone in children.

关 键 词：硫酸镁 罗哌卡因 骶管阻滞 

分 类 号：R726.1[医药卫生—儿科]