小儿应用局部浸润麻醉超前镇痛的观察

AN OBSERVATION OF PRE EMPTIVE ANALGESIA WITH LOCAL INFILTRATION ANESTHESIA IN CHILDREN

目的：探讨小儿应用局部浸润麻醉超前镇痛的效果。方法：选择１２０ 例拟行疝囊高位结扎术的患儿（ Ａ Ｓ Ａ Ⅰ～Ⅱ级） 。随机分为三组，每组４０ 例，Ⅰ组：全麻，Ⅱ组：全麻 ＋ 术前局麻。Ⅲ组：全麻＋ 术后局麻。全麻均用氯氨酮和安定，局麻用０ ．５ ％ 普鲁卡因５ 毫升行切口局部封闭。采用观察行为结合计分法，分别于手术后４ 、８ 、１２ 、１６ 、２４ 、３６ 小时行疼痛评分一次。结果：各时间段Ⅰ组疼痛评分均高于Ⅱ组、Ⅲ组（ Ｐ ＜ ０ ．０５ ～０ ．０１） 。而Ⅲ组疼痛评分均高于Ⅱ组（ Ｐ ＜ ０ ．０５ ～０ ．０１） 。结论：术前行切口浸润麻醉在小儿也同样具有超前镇痛效果。

Aim: To study the effect of pre emeptive analgesia with local infiltration anesthesia in children. Method: One hundred and twenty (ASAⅠ～Ⅱ) ill children undergoing herniorrhaphy were randomly and evenly divided into three groups (n=40) according to the types of anesthsia: Group Ⅰ, general anesthesia (Dizepam ketamine); groupⅡ, general anesthesia with the addition of local anesthesia before operation (infiltration of the abdominal wall with 0.5% procaine 5 ml along the line of the proposed incision); group Ⅲ, general anesthesia with the addition of local anesthesia after the surgical operation. Pain scores were assessed by the method of combining face scales and behavioral responess of ill children at 4h, 8h, 12h, 16h, 24h and 36h after operation. Results: During the first 36h after operation, pain scores in group Ⅰ were significantly higher than that in group Ⅱ and group Ⅲ (P<0.05～0.01), and pain scores in Group Ⅲ were significantly higher than that in Group Ⅱ (P<0.05～0.01). Conclusion: The local infiltration anesthesia provided pre emeptive analgesic effect in children.