曲马多骶管注入用于小儿术后镇痛的初步研究

Pilot study of caudal tramal for postoperative analgesia in pediatrics

目的 观察骶管注入 1mg/kg曲马多用于小儿术后镇痛的效果和安全性。方法 90例在骶麻下行斜疝修补术小儿随机分为 3组 :A组骶管注入 1%利多卡因 ,B组注入 1%利多卡因 + 0 .15 %布比卡因 ,C组注入 1%利多卡因 + 1mg/kg曲马多 ,注药容积为 1ml/kg。术后 4、8、12、2 4h随访并记录疼痛评分 (LPS)及副作用。结果 LPS <3级者B组、C组各时间点明显多于A组 ,平均镇痛时间C组明显长于A、B组 (P <0 .0 1) ,清醒后再嗜睡时间、术后恶心呕吐发生率 3组间无明显差异 ,C组肌力恢复时间、肛门排气时间明显短于B组 (P <0 .0 1)。结论曲马多 1mg/kg骶管注入是小儿斜疝修补术较好的术后镇痛方法之一。

Objective To evaluate the efficacy and side effects of caudal tramal injection for postoperative analgesia in pediatrics. Methods Ninety children(ASAⅠorⅡ)undergoing hernia repair procedures under caudal anesthesia,were randomly assigned to three groups.Group A:1% lidocaine(Lid),group B: 1% Lid+0.15% bupivacaine,group C:1% Lid with 1 mg/kg tramal for caudal analgesia. The degree of pain(LPS),nausea and vomiting(NV) were assessed at 4,8,12 and 24 h after operation. Results The number of LPS<3 were more in group B and C than in group A,the time of average analgesia were longer in group C than in group A and B(P<0.05).NV incidence and re-sleep after anesthesia were similar with three groups. The time of low limb muscle power resume and anus exhaust were shorter in group C than in group B(P<0.05). Conclusion 1 mg/kg tramal caudal injected can produce a better postoperative analgesia in pediatric undergoing hernia repair.