右美托咪定混合利多卡因骶管阻滞用于小儿围术期镇痛管理的评价  

Evaluation of caudal block with dexmedetomidine mixed with lidocaine for management of perioperative analgesia in children

作　　者：杨海扣[1] 拾翠翠[1] 崔恩慧[1] 李茂[1] 孙红梅[1] 陈华军[1] 

机构地区：[1]淮安市妇幼保健院麻醉科,223002

出　　处：《中华麻醉学杂志》2015年第5期590-592,共3页Chinese Journal of Anesthesiology

摘　　要：目的：评价右美托咪定混合利多卡因骶管阻滞用于小儿围术期镇痛管理的效果。方法拟行单侧疝囊高位结扎术的患儿30例，年龄2～6岁，体重8～23 kg，采用随机数字表法分为利多卡因组（ L组）和右美托咪定混合利多卡因组（ DL组），每组15例。 L组骶管注射1％利多卡因1 ml∕kg，DL组骶管注射1％利多卡因1 ml∕kg混合右美托咪定1μg∕kg。 FLACC评分≥4分时口服布洛芬混悬液10 mg∕kg。记录术后8 h内布洛芬使用情况，记录骶管阻滞起效时间和镇痛持续时间，观察不良反应的发生情况。结果与L组比较，DL组患儿骶管阻滞起效时间缩短，镇痛持续时间延长，布洛芬使用率降低（ P＜0．05）；两组不良反应的发生率比较差异无统计学意义（ P＞0．05）。结论骶管注射右美托咪定1μg∕kg可显著优化单纯利多卡因骶管阻滞用于小儿围术期镇痛管理的效果。Objective To evaluate the efficacy of caudal block with dexmedetomidine mixed with lidocaine for management of perioperative analgesia in children. Methods Thirty pediatric patients, aged 2-6 yr, weighing 8-23 kg, scheduled for elective unilateral high ligation of hernial sac, were equally and randomly assigned into either lidocaine group （ group L ） or dexmedetomidine mixed with lidocaine group （ group DL） using a random number table. Each patient received a single caudal dose of 1% lidocaine 1 ml∕kg in group L. Each patient received a single caudal dose of 1% lidocaine 1 ml∕kg mixed with dexmedetomidine 1 μg∕kg in group DL. Postoperative analgesia was assessed using FLACC scale. When FLACC score ≥4, ibuprofen suspension 10 mg∕kg was given orally. The consumption of ibuprofen was recorded within 8 h after operation. The onset time of caudal block and duration of analgesia were recorded, and adverse effects were observed. Results Compared with group L, the onset time of caudal block was significantly shortened, the duration of analgesia was prolonged, and the requirement for ibuprofen was decreased in group L. There was no significant difference in adverse effects between the two groups. Conclusion Addition of dexmedetomidine 1 μg∕kg to caudal lidocaine can significantly optimize the efficacy of caudal block with lidocaine alone for the management of perioperative analgesia in children.

关 键 词：右美托咪啶 利多卡因 麻醉 脊尾 儿童 镇痛 

分 类 号：R726.1[医药卫生—儿科]