颊针对患儿扁桃体腺样体切除术后镇痛效果的影响  

Effect of buccal acupuncture on analgesia after tonsilloadenoidectomy in pediatric patients

作　　者：黄雅莹 杨嘉仪 方婕慧 柯浩翔 徐颖怡 李碧莲 黄俊祥 宋兴荣 余婷婷 Huang Yaying;Yang Jiayi;Fang Jiehui;Ke Haoxiang;Xu Yingyi;Li Bilian;Huang Junxiang;Song Xingrong;Yu Tingting(Department of Anesthesiology,Guangzhou Women and Children's Medical Center,Guangzhou Medical University,Guangzhou 510120,China;College of Pediatrics Guangzhou Medical University,Guangzhou 512120,China)

机构地区：[1]广州医科大学附属妇女儿童医疗中心麻醉与围术期科,广州510120 [2]广州医科大学儿科学院,510120

出　　处：《中华麻醉学杂志》2024年第10期1235-1238,共4页Chinese Journal of Anesthesiology

基　　金：广州市中医药和中西医结合科技项目(20222A011011);广东省中医药局科研项目(20231263)。

摘　　要：目的评价颊针对患儿扁桃体腺样体切除术后镇痛效果的影响。方法本研究为随机对照研究。择期全麻下扁桃体腺样体切除术患儿126例,年龄3~12岁,体质量12~34 kg,ASA分级Ⅰ或Ⅱ级,BMI<30 kg/m^(2)。采用随机数字表法分为2组(n=63):颊针组(B组)和对照组(C组)。所有患儿全麻诱导和术中麻醉维持相同,调整七氟烷浓度维持生命体征指标波动幅度不超过基础值20%。术毕即刻停药并将患儿转运至PACU行全麻复苏。B组术毕气管导管拔除前,取穴双侧颈穴、上颈穴、头部全息穴和中焦穴,一次性针灸针直刺进针,留针20~30 min;C组术后不行颊针。采用疼痛评估量表评价患儿术后疼痛程度,采用Aono四分评级法行患儿术后躁动评分,评估躁动发生情况。记录术后48 h内镇痛泵有效按压次数、补救镇痛情况和恶心呕吐发生情况。记录颊针穿刺点出血、感染、断针的发生情况。结果与C组比较,B组术后镇痛泵有效按压次数和恶心呕吐发生率降低(P<0.05)。2组术后补救镇痛率和躁动发生率比较差异无统计学意义(P>0.05)。B组颊针后未见穿刺部位感染、断针发生;2例穿刺点轻微出血,按压后无异常。结论颊针可增强患儿扁桃体腺样体切除术后镇痛的效果。Objective:To evaluate the effect of buccal acupuncture on analgesia after tonsilloadenoidectomy in pediatric patients.Methods:This was a randomized controlled study.One hundred and twenty-six American Society of Anesthesiologists Physical Status classificationⅠorⅡpediatric patients,aged 3-12 yr,weighing 12-34 kg,with body mass index<30 kg/m^(2),undergoing elective tonsilloadenoidectomy with general anesthesia,were divided into 2 groups(n=63 each)by the random number table method:buccal acupuncture group(group B)and control group(group C).All pediatric patients received the same anesthesia induction and intraoperative anesthesia maintenance.The concentration of sevoflurane was adjusted to keep the fluctuation amplitude of vital sign parameters within 20%of the baseline value.After surgery,the drug was immediately stopped and the children were transferred to the postanesthesia care unit for resuscitation under general anesthesia.In group B,the bilateral neck points,upper neck points,hologram points on the head and Zhongjiao points were selected before removal of the tracheal catheter,and disposable acupuncture needles were inserted directly into the acupoints and remained for 20-30 min.Group C received no buccal acupuncture.The pain Assessment Scale(FLACC)was used to assess the severity of postoperative pain.The postoperative agitation score was evaluated by Aono four-point rating method to evaluate the occurrence of agitation.The effective pressing times of patient-controlled analgesia,rescue analgesia and occurrence of nausea and vomiting within 48 h after operation were recorded.The occurrence of bleeding,infection and broken needle at acupuncture sites was recorded.Results:Compared with group C,the effective pressing times of patient-controlled analgesia and incidence of nausea and vomiting were significantly decreased in group B(P<0.05).There was no significant difference in the rate of rescue analgesia and incidence of postoperative agitation between the two groups(P>0.05).No infection or broken needle wa

关 键 词：针刺 儿童 腺样体切除术 镇痛 病人控制 

分 类 号：R726.1[医药卫生—儿科]