青少年特发性脊柱侧凸后路融合术后以美沙酮为基础的多模式镇痛效果  

Effect of methadone based multimodal analgesia after posterior fusion for adolescent idiopathic scoliosis

作　　者：翟鑫鼎 徐艳红[2] 马小伟 宋万军[4] ZHAI Xin-ding;XU Yan-hong;MA Xiao-wei;SONG Wan-jun(Department of Anesthesia,Miyun Hospital,the First Hospital of Peking University,Beijing 101500,China;Department of Geriatrics,Miyun Hospital,the First Hospital of Peking University,Beijing 101500,China;Department of Thoracic Surgery,Miyun Hospital,the First Hospital of Peking University,Beijing 101500,China;Department of Anesthesia,the Third Hospital of Hebei Medical University,Shijiazhuang,Hebei 050051,China)

机构地区：[1]北京大学第一医院密云院区麻醉科,北京101500 [2]北京大学第一医院密云院区老年医学科,北京101500 [3]北京大学第一医院密云院区胸外科,北京101500 [4]河北医科大学第三医院麻醉科,河北石家庄050051

出　　处：《颈腰痛杂志》2023年第1期60-63,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨美沙酮为基础的多模式镇痛模式对青少年特发性脊柱侧凸患儿术后疼痛和阿片类药物用量的影响。方法选择2018年1月~2020年12月在本院实施PSF的102例患儿作为研究对象,采用随机数字表法分为A组和B组各51例。对照组采用常规自控镇痛为主的多模式镇痛,B组给予美沙酮为基础的多模式镇痛。观察两组患儿术后每日阿片类药物消耗量(吗啡毫克当量,MME)、视觉VAS评分、阿片类药物相关副作用和术后住院时间。结果术后当天,B组疼痛VAS评分和阿片类药物用量显著高于A组(P<0.05);术后第1天,两组患儿疼痛VAS评分和阿片类药物用量差异无统计学意义(P>0.05);术后第2、3天,B组疼痛VAS评分和阿片类药物用量显著低于A组(P<0.05)。A组患者住院时间和首次排便时间均显著长于B组(P<0.05),两组患儿均未观察到呼吸抑制等严重不良反应。结论美沙酮为基础的多模式镇痛可改善AIS患儿PSF术后疼痛控制,降低阿片类药物消耗量。Objective To investigate the effect of methadone based multimodal analgesia on postoperative pain and opioid dosage in adolescent idiopathic scoliosis(AIS).Methods From January 2018 to December 2020,102 children received posterior spinal fusion(PSF)in our hospital were selected in this research,and they were randomly divided into group A and group B,with 51 cases in each group.The control group was given multimodal analgesia based on conventional patient-controlled analgesia,while the group B was given multimodal analgesia based on methadone.The daily opioid consumption[morphine mg equivalent(MME)],VAS score,opioid related side effects and postoperative hospital stay were observed.Results The pain score and opioid dosage in group B were higher than those in group A at the day after surgery(P<0.05).There were no significant differences in pain score and opioid dosage between the two groups at the 1st day after operation(P>0.05).The pain score and opioid dosage of group B were lower than those of group A at the 2nd and 3rd day after operation(P<0.05).The hospitalization time and defecation time of group A were longer than those of group B(P<0.05).No severe adverse reactions such as respiratory depression were observed in both two groups.Conclusion Methadone based multimodal analgesia can improve pain control and reduce opioid consumption in children with AIS after PSF.

关 键 词：青少年特发性脊柱侧凸 后路脊柱融合术 疼痛 美沙酮 多模式镇痛 

分 类 号：R614[医药卫生—麻醉学]