罗哌卡因复合芬太尼连续髂筋膜腔隙阻滞用于小儿股骨手术后镇痛的效果

Continuous fascia iliaca compartment blockade with ropivacaine combined with fentanyl for postoperative pain control in femoral fracture children

目的:观察罗哌卡因复合芬太尼连续髂筋膜腔隙阻滞用于小儿股骨手术后镇痛的效果。方法:选择小儿股骨骨折患儿60例,分为I、F组。手术结束后,两组患儿接受病人自控镇痛(PCA):I组行芬太尼患者自控静脉镇痛;F组行罗哌卡因复合芬太尼连续髂筋膜腔隙阻滞镇痛。于术后48h内各观察时点记录疼痛评分、镇静评分、PCA按压次数、不良反应发生情况、镇痛满意度及患儿生命体征。结果:疼痛评分:F组在术后0.5、1、2、4、8、12h低于I组(P<0.05)。镇静评分:F组在各时点低于B组(P<0.05)。PCA按压次数:F组少于I组(P<0.05)。F组恶心呕吐发生率低于I组(P<0.05)。镇痛满意度:F组高于I组(P<0.05)。结论:罗哌卡因复合芬太尼连续髂筋膜腔隙阻滞用于小儿股骨手术后镇痛效果好,不良反应发生低,是一种安全有效的镇痛方法。

AIM：To investigate the analgesic effect and safety of continuous fascia iliaca compartment blockade with ropivacaine combined with fentanyl for postoperative pain control in femoral fracture children.METHODS：60children with femoral fracture,American Society of Anesthesiologists physical status I or II,were enrolled in this study.The patients were divided randomly into two groups,which received patient-controlled analgesia at the end of operation for 48 hours.Group I was given intravenous fentanyl only,and Group F was given continuous fascia iliaca compartment blockade with ropivacaine combined with fentanyl.Any children with pain score 3were administered with a bolus injection（＂press＂）.The vital signs（HR,RR,BP）, SpO2,score of pain and sedation,degree of satisfaction,frequency of press,adverse reactions were recorded postoperatively at 0.5,1,2,4,8,12,24 hand 48h.RESULTS：Compared with Group I,the pain score of Group F was lower at 0.5,1,2,4,8hand 12h（P〈0.05）;the sedation score of Group F was lower at all time points（P〈0.05）;the times of press of Group F was lower（P〈0.05）;the incidence of nausea and vomiting in Group F was lower（P〈0.05）.CONCLUSION：Continuous fascia iliaca compartment blockade with ropivacaine combined with fentanyl is safe and reduces the incidence of postoperative adverse reactions,providing better postoperative pain control in femoral fracture children.