小儿术后硬膜外自控镇痛的临床效果

Clinical Effects of Patient controlled Epidural Analgesia in Children

目的 :探讨小儿术后硬膜外自控镇痛 (PCEA)的可行性和安全性。方法 :术后 5～ 11岁的小儿 40例 ,分成A、B两组。A组镇痛液配方为 0 0 75 %布比卡因 + 0 0 0 12 %丁丙诺啡 (12 μg/ml) ,B组配方与A组相同并加入小剂量氟哌啶 (5 0 μg/ml)。以LCP模式 (负荷量 2 0 5± 0 13ml,持续量 0 82± 0 15ml,PCA量 0 81± 0 16ml)实施PCEA。结果 :B组 2天用量均少于A组 (P <0 0 1～ 0 0 5 )。从三种评分指标 (VASF、Ramsay、D/D)和并发症综合比较分析 ,提示两组均能达到满意的镇痛效果 ,但B组优于A组。结论 :小儿术后用 0 0 75 %布比卡因 +丁丙诺啡行PCEA是安全有效的 。

Objective:To evaluate the feasibility and safety of postoperative patient controlled epidural analgesia (PCEA) in children.Methods:Forty postoperative pediatric patients(5 11 years old)were divided into two groups.A and B.Both were instituted with postoperative PCEA with LCP model (loading dose 2 05±0 13ml), continuos infusion rate 0 82±0 15ml/h,PCA dose 0 81±0 16ml)by Graseby 9300 PCA pump.The PCEA solution of group A was 0 075% bupivacaine plus 0 0012% buprenorphine,that of group B was same while 0 005% droperidol was added as an adjuvant.Results:The volume of PCEA sdution consumption in group B was significantly less than that in group A on the first and second postoperative day ( P< 0 01 0 05).Good analgesic efficiency with little side effects was obtained,as evaluated by the VAS F,Remasay or D/D score and complications in two groups,but the analgesic effect of group B was better than that of group A.Conclusion:The pediatric PCEA with low concentration of bupivacaine plus buprenorphine is feasible and safe.Droperidol may enhance the analgesic effects of PCEA.