地佐辛预先镇痛在小儿扁桃体和腺样体切除术后镇痛的应用

Efficacy of pre-emptive analgesia with dezocine for postoperative pain in children undergoing tonsillectomy and adenoidectomy

目的观察地佐辛、氯胺酮、曲马朵预先给药用于全麻下小儿扁桃体切除术后的镇痛效果及安全性。方法择期在全麻下行扁桃体、腺样体切除的患儿80例，分为4组，每组20例。于手术开始前10min分别静脉注射地佐辛0．5mg·kg-1、氯胺酮0．5mg·kg-1、曲马朵2mg·kg。及等容量生理盐水。观察术后镇痛、镇静评分、术后躁动的例数及不良反应。结果术后8h时，地佐辛组VAS评分低于其他组；地佐辛组MOPS评分低于生理盐水组（P〈0．05）。地佐辛组不良反应较其他组少（P〈O．05）。结论地佐辛预先镇痛效果良好，优于氯胺酮与曲马朵，且不增加不良反应，可安全有效地用于小儿扁桃体和腺样体切除术后镇痛。

Objective To observe the safety and postoperative analgesic efficacy of dezocine, ketamine and tramadol used pre-emptively in tonsillectomy and adenoideetomy. Methods Eighty children with tonsillectomy and adenoidectomy under general anesthesia were randomly divided into four groups, 20 cases in each group. Dezocine 0.5 mg okg-1 , ketamine 0.5 mg .kg-1 , tramadol 2 mg kg〈 and normal saline were intravenously injected in different groups successively at 10 minutes before the surgery. Postoperative analgesia scoring, agitation during the postoperative period and adverse effects were recorded. Results VAS was significantly lower in dezocine group than that in other groups, and MOPS was lower in dezocine group than that in control group at 8 h after the oper ation （P（0.05）. The number of adverse effects was significantly fewer in dezocine group than that in other groups （P〈0.05）. Conclusion The postoperative analgesic efficacy of pre-emptive anal- gesia with dezocine is better and safer for tonsillectomy and adenoidectomy than that with ketamine and tramadol in children, without increasing adverse effects.