预防性镇痛在小儿疝气手术中的疗效观察  

Observation on the Curative Effect of Preventive Analgesia in Pediatric Hernia Surgery

作　　者：周平[1] 蒋志平[1] 鄢冬梅 刘寒丹 ZHOU Ping;JIANG Zhi-ping;YAN Dong-mei;LIU Han-dan(Suizhou Maternal and Child Health Hospital,Suizhou,Hubei 441300,Chi-na)

机构地区：[1]随州市妇幼保健院,湖北随州441300

出　　处：《湖北医药学院学报》2022年第5期494-498,共5页Journal of Hubei University of Medicine

基　　金：随州市卫生健康委一般项目(2021SZ32067)。

摘　　要：目的:探讨预防性镇痛在小儿疝气手术中的疗效。方法:收集我院2020年1月-2022年3月择期疝气手术患儿共60例,分3组,每组各20例。3组麻醉方式、麻醉诱导相同,对照组患者仅术前10 min接受超前负荷,患儿术后哭闹静脉推注地西泮,肛塞双氯芬酸钠栓;术后镇痛组为手术结束前10 min负荷剂量+术后电子镇痛泵;预防性镇痛组为术前10 min给予超前负荷+手术结束前10 min负荷剂量+术后电子镇痛泵。结果:麻醉结束时预防性镇痛组患儿的FLACC评分低于术后镇痛组,术后镇痛组评分低于对照组。术中预防性镇痛组和对照组患儿生命体征参数(心率、血压、呼吸频率)与术后镇痛组比较,差异有统计学意义(P<0.05);预防性镇痛组和术后镇痛组术后各时间点的生命体征参数(心率、血压、呼吸频率)与对照组比较,差异明显具有统计学意义(P均<0.05)。3组术中及术后的生命体征参数氧饱和度比较,差异无统计学意义(P>0.05)。3组患儿不良反应发生率比较,对照组恶心呕吐、嗜睡的发生率较高,差异有统计学意义(P<0.05)。对照组追加药物例数最多,同预防性镇痛组和术后镇痛组比较,差异具有统计学意义(P<0.05);预防性镇痛组和术后镇痛组患儿家属的满意度较高,对照组最低,差异具有统计学意义(P<0.05)。结论:预防性镇痛用于小儿术后镇痛,通过多模式镇痛能获得满意的镇痛效果且安全有效,值得在临床上推广。Objective To investigate the effect of preventive analgesia in pediatric hernia surgery.Methods A total of 60 children with elective hernia surgery in our hospital from January 2020 to March 2022 were collected and divided into 3 groups with 20 cases in each group.The anesthesia methods and induction of anesthesia were the same in the three groups.The control group received preload only 10 minutes before the operation.The children who cried after the operation received intravenous injection of diazepam and anal plug with diclofenac sodium suppository.The postoperative analgesia group received the loading dose 10 minutes before the end of operation+postoperative electronic analgesic pump.Preventive analgesia group was given preload 10 min before operation+loading dose 10 min before the end of surgery+postoperative electronic analgesic pump.Results At the end of anesthesia,the FLACC score of children in the preventive analgesia group was lower than that in the postoperative analgesia group,and the score of children in the postoperative analgesia group was lower than that in the control group.The preoperative vital signs(heart rate,blood pressure,respiratory rate,of children in the preventive analgesia group and the control group were significantly different from those in the postoperative analgesia group(P<0.05).The vital sign parameters(heart rate,blood pressure,respiratory rate)of the preventive analgesia group and postoperative analgesia group at each time point after operation were significantly different from those of the control group(P<0.05).There was no significant difference in oxygen saturation of vital sign parameters between the three groups during and after operation(P>0.05).Compared the incidence of adverse reactions among the three groups,the incidence of nausea,vomiting and lethargy in the control group was higher,and the difference was statistically significant(P<0.05).The number of cases with additional drugs in the control group was the largest,which was statistically significant compared with th

关 键 词：预防性镇痛 术后镇痛 超前负荷 小儿疝气 舒芬太尼 

分 类 号：R726.1[医药卫生—儿科]