不同剂量右美托咪定骶管阻滞对儿童包皮环切术后的镇痛效果研究

Analgesic Effect of Different Doses of Dexmedetomidine Block on Circumcision in Children

目的分析不同剂量右美托咪定骶管阻滞对儿童包皮环切术后的镇痛效果。方法 2015年3月—2018年8月,于广东省广州市白云区妇幼保健院行包皮环切术的患儿中选取100例,随机分为两组,各50例。两组均行0.25%罗哌卡因+右美托咪定骶管阻滞,对照组右美托咪定应用剂量为1μg/kg,观察组为2μg/kg,比较两组不同时间点FLACC疼痛评分、苏醒躁动评分、补救镇痛情况。结果观察组躁动1级患儿构成比为70%,高于对照组的50%,4级患儿构成比为14%,低于对照组的14%,组间比较差异有统计学意义(P<0.05);与对照组比较,观察组术后4h、术后6h、术后12h、术后16h、术后24h的FLACC疼痛评分更低,组间差异有统计学意义(P<0.05);观察组患儿补救镇痛率为2%(1/50),高与对照组的14%(7/50),组间差异有统计学意义(P<0.05)。结论 0.25%罗哌卡因+2μg/kg右美托咪定骶管阻滞在儿童包皮环切术后镇痛效果显著,可将其广泛推广。

Objective To analyze the analgesic effect of different doses of dexmedetomidine block for children with circumcision.Methods From March 2015 to August 2018,100 patients were enrolled in Guangzhou Baiyun District Maternal and Child Health Hospital for circumcision.They were randomly divided into two groups,50 cases in each group.Both groups received 0.25%ropivacaine+dexmedetomidine.In the control group,the dose of dexmedetomidine was 1μg/kg in the control group and 2μg/kg in the observation group.The FLACC pain score,the wakefulness score,the recovery time and the remedial analgesia were compared between the two groups.Results The composition ratio of children in the observation group was 70%,which was higher than 50%in the control group,14%in the fourth-grade children,and 14%lower than the control group.The difference between the groups was statistically significant(P<0.05).Compared with the control group,the FLACC pain scores were lower in the observation group 4 h after surgery,6 h after surgery,12 h after surgery,16 h after surgery,and 24 h after surgery.The difference between the groups was statistically significant(P<0.05);The remedy analgesia rate was 2%(1/50)in the observation group,and 14%(7/50)in the control group.There was a statistically significant difference between the two groups(P<0.05).Conclusion 0.25%ropivacaine+2μg/kg dexmedetomidine block has significant analgesic effect after circumcision in children,which can be widely promoted.