氢吗啡酮复合罗哌卡因骶管阻滞在儿童尿道下裂手术中的应用效果

The utilization of ropivacaine combined with hydromorphone in caudal block for children undergoing hypospadias surgery

目的探究氢吗啡酮复合罗哌卡因骶管阻滞应用于儿童尿道下裂手术的有效性及安全性。方法将110例行尿道下裂成型术的男性患儿(0~4岁)随机分为R组(骶管阻滞:0.20%罗哌卡因1 mL/kg)以及HR组(骶管阻滞:氢吗啡酮10μg/kg+0.20%罗哌卡因1 mL/kg),每组55例。比较2组患儿术后镇痛时间,术后1、6、12、18、24 h加拿大东安大略儿童医院疼痛评分(CHEOPS),麻醉时间、手术时间、苏醒时间以及术后不良反应之间的差异。结果与R组相比,HR组患儿术后镇痛时间更长(P<0.01),术后12 h和18 h CHEOPS评分更低(P<0.05),2组患儿术后不良反应发生率比较差异无统计学意义(P>0.05)。结论氢吗啡酮复合罗哌卡因骶管阻滞能够安全地应用于小儿骶管麻醉,并有效延长术后镇痛时间,改善患儿术后恢复质量。

Objective To evaluate the efficacy and safety of ropivacaine combined with hydromorphone in caudal block for children undergoing hypospadias surgery.Methods A total of 110 male children aged 0-4 years old who underwent hypospadias surgery were randomly divided into the R group(received caudal block with 0.2%ropivacaine 1 mL/kg)and the HR group(received caudal block with 0.2%ropivacaine 1 mL/kg and hydromorphone 10μg/kg)with 55 children for each group.Anesthesia time,operation time,postoperative Children’s Hospital of Eastern Ontario Pain Scale(CHEOPS)pain scores and complications were recorded and compared between the two groups.Results Compared with the R group,the duration of analgesia time was longer in the HR group(P<0.05),and the 12 h and 18 h CHEOPS pain scores after surgery were lower in the HR group(P<0.05).There were no significant differences in the postoperative complications between the two groups(P>0.05).Conclusion The utilization of ropivacaine combined with hydromorphone in caudal block is safe and effective in children undergoing hypospadias surgery.This method could significantly prolong analgesic time of caudal block and improve the postoperative recovery quality.