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| 超声引导改良阴茎背神经阻滞联合酮咯酸氨丁三醇预先镇痛用于患儿包皮环切术的效果 |
| Efficacy of preemptive analgesia with ultrasound-guided modified dorsal penile nerve block combined ketorolac tromethamine for circumcision in pediatric patients |
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| DOI： |
| 中文关键词: 超声引导 阴茎背神经阻滞 酮咯酸氨丁三醇 患儿 包皮环切术 |
| 英文关键词: Ultrasound-guided Dorsal penile nerve block Ketorolac tromethamine Children patients Circumcision |
| 基金项目:金坛科技局科技计划项目(JT2015061) |
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| 中文摘要: |
目的 观察超声引导改良阴茎背神经阻滞联合酮咯酸氨丁三醇预先镇痛用于患儿包皮环切术的效果。
方法 选择包皮环切术的患儿45例, ASA Ⅰ级。采用随机数字表法分为三组，每组15例。三组均采用相同的静脉麻醉,A组与B组术前在超声引导下行改良阴茎背神经阻滞,给予0.2%罗哌卡因+0.8%利多卡因混合液0.1 ml/kg;A组与C组术前肌注酮咯酸氨丁三醇1 mg/kg。记录丙泊酚和舒芬太尼总用量、术中呼吸抑制和体动反应、PACU苏醒时间、苏醒后至出PACU时间、术后躁动、恶心、呕吐、瘙痒等不良反应以及术后使用对乙酰氨基酚栓补救镇痛的例数。
结果 与C组比较,A组与B组丙泊酚和舒芬太尼总用量明显减少,术中体动和呼吸抑制发生率明显降低,苏醒时间和苏醒后至出PACU时间明显缩短,对乙酰氨基酚栓使用率明显降低(P<0.05)。A组对乙酰氨基酚栓使用率明显低于B组(P<0.05)。三组均未发生恶心、呕吐或瘙痒等不良反应,三组术后躁动发生率差异无统计学意义。
结论 超声引导改良阴茎背神经阻滞联合酮咯酸氨丁三醇预先镇痛用于患儿包皮环切术安全有效且具有良好的术后镇痛效果。 |
| 英文摘要: |
Objective To investigate the efficacy of preemptive analgesiawith ultrasound-guided modified dorsal penile nerve block combined ketorolac tromethamine for circumcision in pediatric patients.
Methods Forty-five pediatric patients with ASA grade Ⅰ undergoing elective circumcision were randomly divided into 3 groups (n=15 each). The same intravenous compound anesthesia was used in the three groups. The pediatric patients underwent ultrasound-guided modified dorsal penile nerve block with a mixture of 0.1 ml/kg of 0.2% ropivacaine and 0.8% lidocaine before operation in group A and group B. The pediatric patients were given ketorolac tromethamine 1 mg/kg intramuscular injection before operation in group A and group C. The total consumption of propfol and sufentanil, occurrence of intraoperative body movement and respiratory depression, emergence time, time from waking up to going out of PACU and adverse reactions such as postoperative agitation, nausea, vomiting and pruritus were aslo recorded. The requirement for postoperative paracetamol suppositories was recorded.
Results Compared with group C, the total consumption of propfol and sufentanil were significantly decreased, incidence of body movement andrespiratory depression were significantly decreased, the emergence time and time from waking up to going out of PACU was significantly shortened, requirement for paracetamol suppositories were significantly decreased in group A and group B (P<0.05). Compared with group B, incidence of requirement for paracetamol suppositories was significantly decreased in group A (P<0.05). No pediatric patients developed postoperative nausea, vomiting, pruritus and incidence of emergence agitation had no statistical difference in the three groups.
Conclusion Preemptive analgesia with ultrasound-guided modified dorsal penile nerve block combined ketorolac tromethamine is safe and effective when used for circumcision in pediatric patients, and it has good efficacy of postoperative analgesia. |
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