氟比洛芬酯联合罗哌卡因棉球用于小儿扁桃体术后镇痛的观察

Observation of tonsils postoperative analgesia by flurbiprofen ester combined with ropivacaine cotton ball in children

目的探讨氟比洛芬酯联合罗哌卡因棉球用于小儿扁桃体切除术后镇痛的效果。方法择期扁桃体切除术患儿60例,ASA分级Ⅰ级,年龄6~12岁,随机分为RF组(氟比洛芬酯联合罗哌卡因组)、R组(罗哌卡因组)、F组(氟比洛芬酯组)各20例。术前15 min,RF组静注氟比洛芬酯1 mg/kg,F组静注氟比洛芬酯1.5 mg/kg,R组静注生理盐水1 mg/kg。RF组与R组在扁桃体切除止血彻底时,用0.5%的罗哌卡因棉球紧紧填塞于扁桃体窝5 min;F组用生理盐水棉球填塞5 min取出棉球。术后采用视觉模拟评分法(visual analogue scale,VAS)评估患儿术后拔管即刻(T0)、术后30 min(T1)、2 h(T2)、4 h(T3)、8 h(T4)、6 h(T5)、12 h(T6)、24 h(T7)的疼痛评分,记录患儿首次追加镇痛药时间、例数以及苏醒期躁动的发生率、恶心、呕吐及呼吸抑制等不良事件的发生率。结果RF组各时点的VAS评分低于F组与R组(P<0.05);R组T0~T4的VAS评分低于F组(P<0.05);RF组术后首次追加镇痛药的时间长于R组和F组(P<0.05);RF组和R组发生苏醒期躁动的比例低于F组(P<0.05)结论氟比洛芬酯联合罗哌卡因用于小儿扁桃体切除术后镇痛效果确切。

Objective To investigate the effect of flurbiprofen axetil combined with ropivacaine cotton ball on analgesia after pediatric tonsillectomy.Methods Sixty children with elective tonsillectomy were enrolled.The ASA gradeⅠ,ages 6-12,were randomly divided into three groups.The RF group was flurbiprofen ester combined with ropivacaine group,R group,ropivacaine group.Group F flurbiprofen ester group,20 cases each.15 min utes before operation,the RF group received intravenous flurbiprofen axetil 1 mg/kg;group F received intravenous flurbiprofen 1.5 mg/kg;group R received intravenous saline 1 mg/kg.In the RF group and the R group,when the tonsillectomy was performed to stop bleeding,0.5%ropivacaine cotton ball was tightly packed in the tonsil socket for 5 min;in the F group,the cotton ball was taken out with a saline cotton ball for 5 minutes.Postoperative extubation was performed immediately(T0),postoperative 30 min(T1),2h(T2),4h(T3),8h(T4),6h(visual analogue scale(VAS)).Pain scores at T5),12h(T6),and 24h(T7).The incidence of first analgesics,the number of cases,and the incidence of agitation during waking,nausea,vomiting,and respiratory depression were recorded.Results The VAS scores of the RF group were lower than those of the F group and the R group(P<0.05).The VAS score of the T0-T4 in the R group was lower than that in the F group(P<0.05).The first analgesic was added to the RF group.The time was longer than that of group R and F(P<0.05).The proportion of arousal agitation in RF group and R group was lower than that in group F(P<0.05).Conclusion Flurbiprofen axetil combined with ropivacaine for better analgesia after pediatric tonsillectomy.