丁哌卡因与芬太尼骶管注入用于小儿术后镇痛的比较

Comparison of bupivaeaine or fentanyl for caudal postoperative analgesia in children

目的:比较小儿骶管注入不同浓度丁哌卡因(B)及芬太尼(F)的镇痛效果和安全性。方法:150例在骶麻下行斜疝修补术小儿随机分为五组:A组骶管注入1%利多卡因(L),B组注1%L+0.15%B,C组注1%L+0.25%B,D组注B组药及2μg·kg^(-1)F,E组注C组药及2μg·kg^(-1)F。术后4、8、12、24小时随访并记录肌力、疼痛评分(LPS)及副作用。结果:LPS<3级:B、C、D、E组各点明显多于A组;平均镇痛时间D组长于B组,E组长于C组;清醒后再嗜睡时间D、E组明显长于其它组,且减少了氯胺酮精神副作用;恶心呕吐D、E组多于A、B、C组;肌力恢复时间C、E组长于A、B、D组。结论:0.15%B(有或无芬太尼)是小儿斜疝修补术后的较好镇痛方法之一。

To compare the efficacy and side effects of bupivaeaine(Bup)at two concentrations and fentanyl for caudal analgesia in children. Method:One hundred-fifty children undergoing hernia repair procedures under caudal anesthesia, were randomly assigned to five groups. Group A: 1% lidocaine (Lid), group B: 10% Lid+0.1% Bup, group C: 1% Lid+0.25% Baeup, group D: 1%Lid+0.15%Bup with 2μg·kg^(-1) fentanyl, group E: 1%Lid+0. 25%Bup with 2μg·kg^(-1) fentanyl for caudal analgesia, The degree of pain(LPS), nausea and vomiting (NV) were as sessed at 4, 8, 12 and 24 h after operation. Result: The numbers of LPS<3 were more in group B,C,D and E than in group A, and were more in group D at 8, 12h than in group B. The time of average analgesia was longer in group D and E than in group B and C. NV incidence was less in group B and C than in group A,and more in group D and E than in group B, C Conclusion: 0.15% bupivacaine (whether contained fentanyl or not) can produce a better postoperative analgesia in children underdoing hernia repair.