纳布啡在小儿术后镇痛中的应用
发布时间：2019-07-05 09:28
【摘要】：[目的]对比纳布啡与舒芬太尼应用于小儿术后镇痛的临床效果,并设置两组不同剂量纳布啡进行临床效果比较,观察纳布啡用于小儿术后镇痛的安全性及有效性,为临床儿科使用纳布啡提供一个剂量参考。[方法]选择择期行扁桃体切除(低温等离子射频消融术)的手术患者120例随机分为4组,每组30例。均于手术结束前10分钟给予PCA,A组:纳布啡1.0 mg/kg+尼松 0.5mg/kg+地塞米松 0.15mg/kg; B 组:纳布啡 1.5mg/kg+尼松 0.5mg/kg+地塞米0.15 mg/kg; C组:舒芬太尼1 μg/kg+尼松0.5 mg/kg+地塞米松0.15 mg/kg;D组:空白组(术后未使用镇痛泵)。[结果]A、B、C三组两两间比较术后FLACC疼痛评分在术后2 h、12 h、24 h、48 h比较差异无统计学意义(P值0.05),在术后4h疼痛评分A组与B、C组比较差异有统计学意义(P值0.05);在术后8h,A、C组与B组比较有统计学意义(P值0.05),A组与C组比较差异无统计学意义(P值0.05),A、B、C三组患儿术后镇静评分比较在术后2 h比较差异无统计学意义(P0.05),在术后4h、8h, A、C组与B组比较差异有统计学意义(P值0.05),A、C两组比较差异无统计学意义(P值0.05) , A、B、C三组与D组比较住院时间、术后FLACC疼痛评分、术后镇静评分差异均有统计学意义(P值0.05)。[结论]1 mg/kg纳布啡复合尼松及地塞米松用于小儿轻、中度术后静脉镇痛效果好,镇静效果满意,能有效减少术后烦躁,不良反应少,可安全用于小儿术后镇痛。
[Abstract]:[objective] to compare the clinical effects of naborphine and sufentanil in postoperative analgesia in children, and to compare the clinical effects of naborphine with sufentanil in different doses, so as to observe the safety and effectiveness of naborphine in postoperative analgesia in children, and to provide a dose reference for clinical use of naborphine in pediatrics. [methods] 120 patients undergoing elective tonsillectomy (hypothermic plasma radiofrequency ablation) were randomly divided into 4 groups with 30 patients in each group. All patients were given PCA,A 10 minutes before the end of operation: naborphine 1.0 mg/kg nisone 0.5mg/kg dexamethasone 0.15 mg 路kg, group B: naborphine 1.5mg/kg 0.5mg/kg desemide 0.15 mg / kg, group C: sufentanil 1 渭 g/kg nison 0.5mg/kg dexamethasone 0.15 mg 路kg ~ (- 1), group D: control group (no analgesic pump after operation), group C: sufentanil 1 渭 g/kg nison dexamethasone 0.15 mg 路kg ~ (- 1), group D (no analgesic pump after operation), group B (naborphine 1.0 mg 路kg ~ (- 1). [results] there was no significant difference in FLACC pain score between group A and group B at 2 h, 12 h, 24 h and 48 h after operation, but there was significant difference between group A and group B at 4 h after operation (P < 0.05). At 8 hours after operation, there was significant difference between group C and group B (P < 0.05). There was no significant difference in postoperative sedation score between group C and group B (P < 0.05). There was no significant difference in sedation score between group C and group B at 2 h after operation (P < 0.05). At 4 h, 8 h after operation, there was significant difference between group C and group B (P < 0.05), A,). There was no significant difference between group C and group D (P < 0.05). There was no significant difference in hospitalization time, postoperative FLACC pain score and sedation score between group A, group B and group D. [conclusion] 1 mg/kg naborphine combined with nisolone and dexamethasone has good intravenous analgesia effect and satisfactory sedation effect in children with mild and moderate postoperative analgesia. It can effectively reduce postoperative irritability and less adverse reactions, so it can be safely used in postoperative analgesia in children.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R726.1
本文编号：2510432
[Abstract]:[objective] to compare the clinical effects of naborphine and sufentanil in postoperative analgesia in children, and to compare the clinical effects of naborphine with sufentanil in different doses, so as to observe the safety and effectiveness of naborphine in postoperative analgesia in children, and to provide a dose reference for clinical use of naborphine in pediatrics. [methods] 120 patients undergoing elective tonsillectomy (hypothermic plasma radiofrequency ablation) were randomly divided into 4 groups with 30 patients in each group. All patients were given PCA,A 10 minutes before the end of operation: naborphine 1.0 mg/kg nisone 0.5mg/kg dexamethasone 0.15 mg 路kg, group B: naborphine 1.5mg/kg 0.5mg/kg desemide 0.15 mg / kg, group C: sufentanil 1 渭 g/kg nison 0.5mg/kg dexamethasone 0.15 mg 路kg ~ (- 1), group D: control group (no analgesic pump after operation), group C: sufentanil 1 渭 g/kg nison dexamethasone 0.15 mg 路kg ~ (- 1), group D (no analgesic pump after operation), group B (naborphine 1.0 mg 路kg ~ (- 1). [results] there was no significant difference in FLACC pain score between group A and group B at 2 h, 12 h, 24 h and 48 h after operation, but there was significant difference between group A and group B at 4 h after operation (P < 0.05). At 8 hours after operation, there was significant difference between group C and group B (P < 0.05). There was no significant difference in postoperative sedation score between group C and group B (P < 0.05). There was no significant difference in sedation score between group C and group B at 2 h after operation (P < 0.05). At 4 h, 8 h after operation, there was significant difference between group C and group B (P < 0.05), A,). There was no significant difference between group C and group D (P < 0.05). There was no significant difference in hospitalization time, postoperative FLACC pain score and sedation score between group A, group B and group D. [conclusion] 1 mg/kg naborphine combined with nisolone and dexamethasone has good intravenous analgesia effect and satisfactory sedation effect in children with mild and moderate postoperative analgesia. It can effectively reduce postoperative irritability and less adverse reactions, so it can be safely used in postoperative analgesia in children.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R726.1
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