超声引导下腰方肌阻滞对小儿疝囊高位结扎术术后镇痛效果评价  

Evaluation of analgesic effect by ultrasound-guided lumbar muscle block for postoperative high ligation of hernia sac in children

作　　者：欧阳辉旺[1] 叶玉萍[1] 刘国栋[1] 王正坤[1] 刘涌[1] OUYANG Huiwang;YE Yuping;LIU Guodong;WANG Zhengkun;LIU Yong(Department of Anesthesiology,Foshan Maternal and Child Health Care Hospital,Foshan 528000,China)

机构地区：[1]佛山市妇幼保健院麻醉科

出　　处：《实用医学杂志》2019年第11期1816-1819,共4页The Journal of Practical Medicine

基　　金：佛山市科技局科研课题[编号:佛科(2017)125号]

摘　　要：目的探讨超声引导下腰方肌阻滞(QLB)对小儿疝囊高位结扎术术后的镇痛效果。方法选取2017年10月至2018年11月于行疝囊高位结扎术的小儿共80例,随机分为QLB组和对照组,每组40例,QLB组在术前采用超声引导下QLB(0.25%0.5 mL/kg罗哌卡因),对照组则采用生理盐水的进行注射,比较两组术后4、12、24 h的FLACC评分和Ramsay镇静评分、术后镇痛剂使用量,记录两组患儿术后住院时间和不良反应。结果 QLB组的平均手术时间、麻醉时间、拔管时间和苏醒时间与对照组比较无统计学差异(P> 0.05),而QLB组术后平均住院时间显著少于对照组(P <0.05),QLB组患儿术后4 h、12 h和24 h的FLACC评分显著低于对照组(P <0.05),且QLB组患儿术后3d的平均曲马多用量显著低于对照组(P <0.05),QLB组患儿其术后4 h、12 h和24 h的Ramsay镇静评分和不良反应与对照组比较差异均无统计学意义(P> 0.05)。结论超声引导下QLB阻滞技术在小儿疝囊高位结扎术中应用能显著缓解患儿术后的疼痛,减少镇痛剂的使用和术后住院时间,其临床安全性良好。Objective To investigate the analgesic effect of ultrasound-guided lumbar muscle block(QLB)on high ligation of sac in children. Methods A total of 80 pediatrics who underwent high ligation of hernia sac from October 2017 to November 2018 were enrolled,randomly divided into QLB group and control group,40 cases in each group. In the QLB group,QLB was used before surgery(0.25% 0.5 mL/kg ropivacaine),while the control group was injected with normal saline. FLACC and Ramsay scores were compared at 4 h,12 h,and 24 h after operation. The postoperative analgesic doses,and the postoperative hospital stay and adverse reactions were recorded. Results There was no significant difference in the mean operative time,anesthesia time,extubation time and recovery time between the two groups(P > 0.05). The average hospital stay in the QLB group was significantly lower than the control group(P < 0.05),the FLACC scores of the QLB group were significantly lower than the control group at 4 h,12 h and 24 h after operation(P < 0.05),The average amount of tramadol in the QLB group was significantly lower than that in the control group(P < 0.05). There were no significant differences in the Ramsay sedation scores and adverse reactions between the QLB group and the control group at 4 h,12 h and 24 h after operation(P > 0.05). Conclusion Ultrasound-guided QLB block technique can significantly alleviate postoperative pain,reduce the use of analgesics and postoperative hospitalized stay in children with high ligation of hernia sac,and the clinical safety is good.

关 键 词：腰方肌阻滞 儿童 疝气 镇痛 安全性 

分 类 号：R726.1[医药卫生—儿科]