超声引导阻滞麻醉对疝囊高位结扎术患儿术后FLACC评分和Ramsay镇静评分的影响

Effect of ultrasound-guided block anesthesia on FLACC and Ramsay sedation scores of children after high ligation of hernia sac

目的分析超声引导阻滞麻醉对疝囊高位结扎术患儿术后FLACC评分和Ramsay镇静评分的影响。方法选取本院2018年7月至2019年3月收治的90例接受疝囊高位结扎术治疗的患儿,将数字随机方法将其分成对照组与实验组,各45例;实验组于术前选择超声引导下腰方肌阻滞麻醉,对照组选择生理盐水注射,观察比较两组患者的镇痛、镇静效果。结果实验组的术后住院时间为(3.8±1.4)d,明显短于对照组的(5.1±1.5)d,两组比较差异有统计学意义(P<0.05)。实验组术后3 d的曲马多平均用量为(14.3±5.4)mg,明显少于对照组的(38.2±6.8)mg,两组比较差异有统计学意义(P<0.05)。实验组术后4 h、12 h、24 h的FLACC评分分别为(2.1±1.4)分、(1.5±0.3)分、(1.3±0.3)分,均明显低于对照组的(3.6±1.2)分、(2.7±0.6)分、(3.3±0.5)分,两组比较差异有统计学意义(P<0.05)。对照组术后4 h、12 h、24 h的Ramsay镇静评分分别为(2.5±0.5)分、(2.4±0.5)分、(2.3±0.4)分,实验组分别为(2.6±0.4)分、(2.3±0.4)分、(2.2±0.4)分,两组比较差异无统计学意义(P>0.05)。结论在疝囊高位结扎术患儿中应用超声引导阻滞麻醉,能对术后疼痛进行有效缓解,让镇痛剂用量减少,缩短术后住院时间,具有较高的安全性,具有临床推广价值。

Objective To analyze the influence of ultrasound-guided block anesthesia on FLACC and Ramsay sedation scores of children after high ligation of hernia sac.Methods 90 children who received high ligation of hernia sac in our hospital from July 2018 to March 2019 were randomly divided into control group and experimental group with 45 cases in each group.The experimental group was anesthetized by quadratus lumborum block under the guidance of ultrasound before operation,and the control group was injected with normal saline.The analgesic and sedative effects were observed.Results The postoperative hospitalization time of the experimental group was(3.8±1.4)d,which was significantly shorter than that of the control group[(5.1±1.5)d],the difference was statistically significant(P<0.05).The average dosage of tramadol in the experimental group was(14.3±5.4)mg,which was significantly lower than that in the control group[(38.2±6.8)mg],the difference was statistically significant(P<0.05).The FLACC scores of the experimental group at postoperative 4 h,12 h and 24 h were(2.1±1.4),(1.5±0.3),(1.3±0.3)respectively,which were significantly lower than those of the control group[(3.6±1.2),(2.7±0.6),(3.3±0.5)],and the differences were statistically significant(P<0.05).Ramsay sedation scores of the control group at postoperative 4 h,12 h and 24 h were(2.5±0.5),(2.4±0.5),(2.3±0.4)respectively,and those of the experimental group were(2.6±0.4),(2.3±0.4),(2.2±0.4),respectively,there were no statistically significant differences between the two groups(P>0.05).Conclusion The application of ultrasound-guided block anesthesia in children with high ligation of hernia sac can effectively relieve the postoperative pain,reduce the dosage of analgesics,and shorten the postoperative hospital stay,which has high safety and clinical value.