右美托咪定在小儿尿道下裂术后骶管阻滞麻醉镇痛中的应用

Application of Dexmedetomidine in Analgesia of Sacral Anesthesia after Urethroplasty for Children Hypospadias

目的：探讨小儿尿道下裂手术后，右美托咪定对术后罗哌卡因骶管阻滞镇痛效果的影响。方法选择40名年龄5-7岁患儿，ASAⅠ-Ⅱ级，无先天性心血管疾病、贫血，无右美托咪定过敏者，随机分入DR （2ug/kg右美托咪定和0.25%罗哌卡因）组和R（0.25%罗哌卡因）组，每组20人。观察FLACC小儿疼痛评分，以及镇痛药物使用人数、时间、用量。结果两组患儿FLACC术后24h疼痛评分有差异，术后4h有显著差异（P〈0.05），镇痛药物使用人数、开始使用时间、使用量有显著差异（P〈0.05）。结论右美托咪定复合罗哌卡因在小儿尿道下裂术后骶管阻滞镇痛中能有效减轻患儿疼痛，减少镇痛药物的应用。

Objective To observe the affection of dexmedetomidine in analgesia of sacral anesthesia with ropivacaine after urethro-plasty for children hypospadias. Methods 40 children with hypospadias of ASA grading from I to II,aged from 5 to 7 years old,with no congenital cardiovascular diseases,no anemia and no allergic history to dexmedetomidine,were randomly divided into 2 groups：DR group and R group,20 in each;0.25%ropivacaine was given to all the children in both groups while 2ug·kg-1 dexmedetomidine was added to children in DR group;the FLACC children pain scores,the analgesic drug application including the case number,the alloca-tion time and the drug dose in both groups were observed and compared. Results There existed a difference in FLACC children pain scores between the 2 groups,with the significant difference at the 4th hour after operation （P〈0.05）,as well as in the case number,the application time and the drug dose （P〈0.05）. Conclusions Dexmedetomidine in addition to ropivacaine in analgesia of sacral anesthesia can effectively cut down the pain in the children and decrease the application of analgesic drugs.