小儿唇腭裂术后不同方法镇痛的临床观察

Observation of the effect on post-operation of cheilopalatognathus in children with different methods of analgesia

目的探讨不同镇痛方式在小儿唇腭裂手术后应用的效果。方法择期唇腭裂手术患儿40例。随机分为布洛芬混悬液口服组和对乙酰氨基酚栓塞肛组,每组20例。应用视图疼痛评分(LPS)观察术后镇痛效果。记录两组患儿术前、术后6、12、24h的HR、MAP、RR、SpO2等临床指标。观察并记录术后恶心呕吐、胃肠道出血、皮疹、水肿、血尿及呼吸抑制等不良反应。结果口服组和塞肛组术后镇痛效果无差异(P>0.05)。两组患儿HR、MAP、RR、SpO2术后各时点之间、各时点与术前比较差异无统计学意义(P>0.05)。塞肛组较口服组不良反应发生率少(13%vs33%)。结论小儿唇腭裂手术后,布洛芬混悬液口服和对乙酰氨基酚栓塞肛的给药方式都有满意的镇痛效果,但对乙酰氨基酚栓塞肛方式不良反应少,更安全和可行。

Objective To observe the effect on post-operation of cheilopalatognathus close with two different methods of analgesia. Method 40 patients were randomly divided into 2 groups ： Ibuprofen suspension by oral route（ oral group） and acetaminophen suppository by rectal route （rectal group）. Each group was consist of 20 cases. View pain scale was used to value the effect of analgesia on each patient. The vital sign of 40 patients, including HR, MAP, RR and SpO2, were recorded in pre-operation and post-operation. Side effects such as vomiting, bleeding, hematuria and respiratory depression of each group were observed within 24 hour of postoperation. Results There was no difference on effect of analgesia of two groups （ P 〉 0.05 ）. To compare the two groups with HR, MAP, RR , SpO2 in 6,12,24 h post-operation and pre-operatian, no significantly difference was observed（ P 〉0.05 ）. The incidence of side effects was lower in rectal group than that in oral group. Conclusion The two methods of analgesia showed good effect on post-operative cheilopalatognathus close surgery. acetaminophen suppository deliveried by rectal route seems more safe and little side effects.