术前心理干预对小儿漏斗胸矫正术后镇痛效应的影响  

The effect of preoperative psychological intervention on postoperative analgesia for children with funnel chest diorthosis

作　　者：李俊[1] 王子申[1] 马骏[2] 

机构地区：[1]泰山医学院附属医院麻醉科,泰安271000 [2]首都医科大学附属北京安贞医院麻醉中心

出　　处：《国际麻醉学与复苏杂志》2015年第12期1089-1091,共3页International Journal of Anesthesiology and Resuscitation

摘　　要：目的研究术前心理干预联合静脉镇痛对小儿漏斗胸矫正术后镇痛效果的影响。方法选择40例漏斗胸矫正术小儿，小儿除漏斗胸外，无其他系统器质性疾病，采用随机数字表法分为两组（每组20例）：心理干预组（Ⅰ组），术前给予小儿心理干预；对照组（Ⅱ组），常规行围术期准备。两组于手术结束前30min启用电子自控镇痛泵，持续泵入芬太尼量为5ug·kg-1·d-1，2ml／h，锁定时间为15min，输注48h，分别于术后1、6、12、24、36h及48h记录Ramsay镇静评分、疼痛评分，同时记录术后镇痛泵按压次数及相关副作用。结果Ramsay镇静评分Ⅰ组明显高于Ⅱ组（P〈0．05），疼痛评分I组明显低于Ⅱ组（P〈0．05）。术后48h芬太尼总用量Ⅰ组[（9．6±2．0）ug／kg]显著少于Ⅱ组[（13．8±2．2）ug／kg]（P〈0．05）。按压次数及有效次数Ⅱ组[（7．9±1．7）次]显著多于Ⅰ组[（4．8±1．5）次]（P〈0．05）。结论术前心理干预可提高小儿漏斗胸矫正术后镇痛效果，增强小儿对术后疼痛的耐受性，促进患儿顺利康复。Objective To study the postoperative analgesia effect of psychological intervention combined intravenous analgesia effects on children. Methods Forty children were operated funnel chest diorthosis, who had no system disease. These children were divided into two groups randomly with 20 in each group. Patients in group I received psychological intervention before operation. Patients in group Ⅱ were treated as usual. Electronic controlled analgesia pump was used for all patients 30 min before the end of surgery, continuous pumping volume was 5 ug·kg-1 ·d-1 and 2 ml/h, locking time was 15 min, and infusion continued 48 h. Ramsay, pain score and reactions related to postoperation were recorded respectively in postoperative 1, 6, 12, 24, 36 h and 48 h. Results Ramsay sedation scores in group Ⅰ was significantly higher than group Ⅱ （P〈0.05）. Pain scores was lower in group Ⅰ than in group Ⅱ （P〈0.05）. Total dosage of fentanyl in group Ⅰ [ （9.6±2.0） ug/kg] was significantly less than group Ⅱ [ （13.8±2.2） ug/kg] within： 48 h （P〈0.05）. Pressing times was significantly higher in group Ⅱ（ 7.9± 1.7 ） than group Ⅰ （4.8± 1.5 ） （P〈0.05）. Conclusions Preoperative psychological intervention can improve the postoperative analgesia effect of children with funnel chest corrective, enhance children tolerance to postoperative pain, and promote patients recovery.

关 键 词：心理干预 小儿 术后镇痛 

分 类 号：R726.1[医药卫生—儿科]