氟比洛芬酯超前镇痛复合不同剂量的舒芬太尼对小儿骨盆截骨矫形术术后镇痛效果的比较

发布时间：2019-06-17 21:31

【摘要】：目的比较氟比洛芬酯超前镇痛复合不同剂量舒芬太尼对小儿骨盆截骨矫形术术后镇痛的效果,寻找适合小儿的术后镇痛模式。方法:选取我院小儿骨科3～10岁的先天性髋脱位,拟于全麻下行骨盆截骨矫形术患儿90例,根据氟比洛芬酯复合舒芬太尼剂量的不同,将患儿随机分为N1、N2、N3三组。三组PCA舒芬太尼的剂量分别为1.5、2.0或2.5 u g/kg,三组切皮前均给予静脉注射氟比洛芬酯1mg/kg超前镇痛。PCA泵中昂丹司琼含量均为0.1mg/kg,容量加生理盐水至100毫升。记录各组患儿在恢复室的气管插管拔除时间,患儿术后2、4、8、12、24、48h各个时间点的FLACC疼痛评分,术后48h内PCA按压次数、Ramsay镇静评分,恶心、呕吐、呼吸抑制等不良反应等。结果三组患儿在恢复室的术后拔管时间差异无统计学意义(P0.05)。FLACC评分比较,术后4,8和12h,N2组、N3组明显低于N1组,差异有统计学意义(P0.05),N3组低于N2组,差异有统计学意义(P0.05);术后24和48h,N3组低于N1组差异有统计学意义(P0.05)。术后48hPCA泵按压次数,N1组13次,N2组7次,N3组3次,差异有统计学意义(P0.05)。Ramsay评分比较,术后4,8和12h,N2组和N3组明显高于于N1组,差异有统计学意义(P0.05),术后24和48h,N3组高于N1组差异有统计学意义(P0.05)。术后48h恶心,呕吐发生率N3组(8例)明显高于N1组(0例)和N2组(3例),差异有统计学意义(P0.05)。结论氟比洛芬酯1mg/kg超前镇痛复合舒芬太尼2 μ g/kg是一种理想的小儿骨盆截骨矫形术的PCA模式。
[Abstract]:Objective to compare the effect of preemptive analgesia combined with different doses of sufentanil on postoperative analgesia after pelvic osteotomy and orthopaedic surgery in children, and to find a suitable postoperative analgesia mode for children. Methods: 90 children undergoing pelvic osteotomy and orthopaedic surgery under general anesthesia were randomly divided into three groups: N1 group, N2 group and N3 group according to the dose of flubiprofen ester combined with sufentanil. The doses of sufentanil in the three groups were 1.5, 2.0 or 2.5 渭 g 路kg ~ (- 1), respectively. all the three groups were treated with flubiprofen ester 1mg/kg preemptive analgesia before skin incision. The content of ondansetron in the three groups was 0.1 mg 路kg ~ (- 1), and the volume was added to 100ml of saline. The extubation time of tracheal intubation in recovery room was recorded. FLACC pain score, PCA pressing times, Ramsay sedation score, nausea, vomiting, respiratory suppression and other adverse reactions were recorded at each time point at 2, 4, 8, 12, 24 and 48 hours after operation. Results there was no significant difference in extubation time between the three groups (P 0.05). FLACC score in N2 group and N3 group was significantly lower than that in N1 group at 4, 8 and 12 hours after operation (P 0.05), N3 group was lower than N2 group, the difference was statistically significant (P 0.05). 24 and 48 hours after operation, N3 group was significantly lower than N1 group (P 0.05). The number of 48hPCA pump pressing was 13 times in N1 group, 7 times in N2 group and 3 times in N3 group, the difference was statistically significant (P 0.05). Ramsay score was significantly higher in N2 group and N3 group than that in N1 group at 4, 8 and 12 hours after operation, the difference was statistically significant (P 0.05). 24 and 48 hours after operation, the difference between N3 group and N1 group was statistically significant (P 0.05). 48 hours after operation, the incidence of nausea and vomiting in N3 group (8 cases) was significantly higher than that in N1 group (0 cases) and N2 group (3 cases), the difference was statistically significant (P 0.05). Conclusion 1mg/kg preemptive analgesia combined with sufentanil 2 渭 g/kg is an ideal PCA model for pelvic osteotomy and orthopaedic surgery in children.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R726.1

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