曲马多超前镇痛在儿童腹腔镜阑尾切除术中的应用效果

Application of tramadol preemptive analgesia in children undergoing laparoscopic appendectomy

目的:研究曲马多超前镇痛在儿童腹腔镜阑尾切除术中的应用效果。方法:选取我院2019年1月至2019年12月期间接受手术治疗的按美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级法诊断为Ⅰ级小儿阑尾炎的60例患者作为研究对象,根据镇痛方式不同随机分为试验组和对照组。试验组患儿(n=30)采用曲马多1.5 mg·kg^-1进行术前超前镇痛,对照组患儿(n=30)采用曲马多1.5 mg·kg^-1进行术后常规镇痛。比较患儿手术前、术中15 min、手术结束以及拔管后平均动脉压(Mean arterial pressure,MAP)、心率(Heart rate,HR)、血氧饱和度(Arterial oxygen saturation,SpO2)的变化;以视觉模拟标定法(Visual analogue scale,VAS)评估术后疼痛程度,并进行Bruggermann舒适度评分(Bruggermann comfort score,BCS)及术后不良反应监测。结果:两组患儿手术前后MAP、HR、SpO2比较,差异均无统计学意义(P>0.05)。试验组术后2 h内BCS评分高于对照组,VAS评分低于对照组(P<0.05)。试验组患儿术后不良反应发生率低于对照组,但差异无统计学意义(23.3%vs 40.0%,P>0.05)。结论:曲马多用于儿童腹腔镜阑尾切除术超前镇痛具有良好效果及安全性。

Objective:To study the effect of tramadol preemptive analgesia in laparoscopic appendectomy in children.Methods:Sixty ASA I children appendicitis patients operated in our hospital from January 2019 to December 2019 were selected as the study objects,and randomly divided into experimental group and control group,according to different analgesic methods.The experimental group(n=30)used tramadol 1.5 mg·kg^-1 for preemptive analgesia,while the control group(n=30)used tramadol 1.5 mg·kg^-1 for routine analgesia.The changes of mean arterial pressure(MAP),heart rate(HR)and arterial oxygen saturation(SpO2)were compared before operation,during operation for 15 minutes,at the end of operation and after extubation.The degree of postoperative pain(visual analogue scale,VAS),comfort(bruggrmann comfort score,BCS)and adverse reactions were compared.Results:There was no significant difference in MAP,HR and SpO2 between the two groups(P>0.05).Within 2 hours after operation,BCS score of experimental group was higher than that of control group,and VAS score was lower than that of control group(P<0.05).The incidence of adverse reactions in the experimental group was lower than that in the control group,but the difference was not statistically significant(23.3%vs 40.0%,P>0.05).Conclusion:Tramadol has a good effect and safety in preemptive analgesia of laparoscopic appendectomy in children.