舒芬太尼联合罗哌卡因切口浸润用于小儿腹部手术术后镇痛的研究

Effect of intravenous sufentanil in combination with ropivacaine wound infiltration for postoperative analgesia in pediatric laparotomy

目的比较舒芬太尼联合罗哌卡因切口浸润与舒芬太尼单独用于小儿腹部大手术术后镇痛的效果。方法纳入行择期腹部手术的患儿80例,随机分为2组:S组单纯使用静脉舒芬太尼0.03μg·kg-1·h-1行术后镇痛;S+R组使用0.25%罗哌卡因1 mL·cm-1切口浸润+静脉舒芬太尼0.03μg·kg-1·h-1镇痛。比较术后1、2、4、8、12、24、48小时的镇痛效果及不良反应的发生情况。疼痛评估采用FLAAC量进行。结果术后1、2、4、8小时,S组患儿的疼痛评分大于3分,明显高于S+R组,有统计学差异(P<0.05),术后12、24、48小时S+R组与S组的疼痛评分没有统计学差异(P>0.05)。2组均未见严重不良反应的发生。结论舒芬太尼联合罗哌卡因切口浸润用于小儿腹部手术术后镇痛能达到更好的镇痛效果。

Objective To evaluate the analgesia effect of intravenous sufentanil in combination with ropivacaine infiltration and intravenous sufentanil for postoperative analgesia in pediatric laparotomy. Methods Eighty children aged 1-4 year scheduled for elective laparotomy were allocated randomly to 2 group. Group S＋R received 0.25% ropivacaine wound infiltration according to the length of the wound （1 ml·cm^-1） before skin closure and intravenous sufentanil 0.03 μg· kg^-1·h^-1 after operation, and group S received only intravenous sufentanil 0.03 μg· kg^-1·h^-1 for postoperative analgesia. The pain density was determined by FLACC at 1, 2, 4, 8, 12, 24, 48 h postoperatively. Results The pain score were significantly higher in group S when compared with group S＋R at 1, 2, 4, 8 h postoperatively （P〈0.05）. There were no difference in the pain score at 12, 24, 48 h. Severe adverse events were not observed in the present study. Conclusion Intravenous sufentanil in combination with ropivacaine wound infiltration provided excellent and safe postoperative analgesia in pediatric laparotomy.