骶管内新斯的明对小儿术后康复的影响  

The effect of caudal neostigmine for postoperative recovery in children

作　　者：于桂杰 吕金[1] 陈卫民[1] 刘嵘[2] 

机构地区：[1]中国医科大学附属第二医院麻醉科,现在辽宁省医院110004 [2]中国医科大学统计教研室

出　　处：《辽宁医学杂志》2003年第6期309-311,共3页Medical Journal of Liaoning

摘　　要：目的　探讨新斯的明伍用吗啡对小儿术后康复的影响。方法　选取 4～ 12岁 ,ASA为Ⅰ Ⅱ级 ,行下腹部手术的小儿 40例为研究对象 ,以静吸复合加骶管麻醉 (骶管注入编号为① /②之一的 1%lidocaine 0 .6ml/kg) ,随机双盲法将实验对象分为两组 ,每组 2 0例 :Ⅰ组 (M组 )Mor 0 .0 2 5mg/kg ;Ⅱ组 (N0 .0 2 M组 )Neo 0 .0 2mg/kg +Mor 0 .0 2 5mg/kg。术后 2、4、8、12、2 4小时对其进行VAS镇痛评分 ,并观察呼吸循环功能状态 ,包括血压、心率、呼吸等生命指征 ,以及恶心、呕吐、皮肤瘙痒、尿潴留等不良反应。结果　术后MAP、HR、SpO2 、RR及手术时间、麻醉时间组间比较无明显差异 (P >0 .0 5)。Ⅱ组术后VAS镇痛评分明显低于Ⅰ组 (P <0 .0 5) ,且Ⅱ组的副作用发生率显著低于Ⅰ组 (P <0 .0 1)。结论　小儿骶管注入新斯的明 0 .0 2mg/kg +吗啡 0 .0 2 5mg/kg ,不但能增强吗啡 0 .0 2 5mg/kg的镇痛效果 ,而且明显减少吗啡的副作用 。Objective To study the effect of caudal neostigmine combined with low dose mophine for postoperative recovery in children. Methods 40 children (aged 4 12 years, ASA grade Ⅰ Ⅱ) undergoing elective lower abdominal surgery under general and caudal anesthesia (caudal solution injected one of 1% lidocaine 0.6 ml/kg numbered ①/ ②), were randomly allocated into 2 groups of 20children each in double blind way. GroupⅠ (M) received MOR 0.025 mg/kg caudally. GroupⅡ (N 0.02 M) received NEO 0.02mg/kg with MOR 0.025 mg/kg caudally. As measured using VAS, effective analgesia was evaluated at 2? 4? 8? 12?24 hours after surgery. This study noted respiratory and circulatory signs, including Bp, HR?R?SpO 2 and side effects (nausea, pruritus, urinary retention,et al.). Results There were no differences within group and between groups on HR, R , MAP and SpO 2(P >0.05). VAS pain scores were significantly lower in group Ⅱ than groupⅠafter operation (P<0.05,). The incidence of side effects in group Ⅱwas lower than in group Ⅰ(P <0.01).Conclusion Caudal neostigmine 0.02mg/kg combined with morphine 0.025mg/kg can enhance the effect of morphine 0.025mg/kg for postoperative analgesia with less side effects and be beneficial for postoperative recovery in children.

关 键 词：新斯的明 小儿 康复 吗啡 骶管麻醉 术后镇痛 

分 类 号：R726.1[医药卫生—儿科]