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| 布洛芬注射液用于腹腔镜下腹股沟斜疝修补术患儿术后镇痛的效果 |
| Postoperative analgesic effect of ibuprofen injection in children undergoing laparoscopic indirect inguinal hernia repair |
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| DOI：10.12089/jca.2021.04.006 |
| 中文关键词: 布洛芬注射液 腹腔镜 腹股沟斜疝修补术 儿童 术后镇痛 |
| 英文关键词: Ibuprofen injection Laparoscopic Indirect inguinal hernia repair Child Postoperative analgesia |
| 基金项目: |
| 作者 | 单位 | E-mail | | 李强 | 330006,江西省儿童医院,南昌大学附属儿童医院麻醉科 | | | 胡华琨 | 330006,江西省儿童医院,南昌大学附属儿童医院麻醉科 | | | 叶玲玲 | 南昌大学第一附属医院麻醉科 | 453043316@qq.com | | 沈世晖 | 330006,江西省儿童医院,南昌大学附属儿童医院麻醉科 | | | 程丽群 | 330006,江西省儿童医院,南昌大学附属儿童医院麻醉科 | | | 李明 | 330006,江西省儿童医院,南昌大学附属儿童医院麻醉科 | |
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| 中文摘要: |
目的 探讨布洛芬注射液用于腹腔镜下腹股沟斜疝修补术患儿的术后镇痛效果。
方法 选择2020年5—12月在我院拟行腹腔镜下腹股沟斜疝修补术患儿300例，其中双侧腹股沟斜疝92例，单侧腹股沟斜疝208例，男278例，女22例，年龄10个月至4岁，体重8.5～22.0 kg，ASA Ⅰ或Ⅱ级。采用随机数字表法随机分为三组：布洛芬注射液组（I组）、布洛芬栓组（S组）和对照组（C组），每组100例。麻醉维持开始时，I组予以布洛芬注射液10 mg/kg静脉滴注，S组予以布洛芬栓（50 mg/粒）约5 mg/kg塞肛，C组予以同I组等量生理盐水静脉滴注，4 h后均重复给药1次。术后均采用舒芬太尼静脉自控镇痛（PCIA）。FLACC评分＞3分时，补充给予舒芬太尼0.05～0.1 μg/kg。记录术后1、2、4、6、8 h的FLACC评分和术后1、1～2、2~4、4~6和6~8 h内FLACC评分＞3分的患儿例数。记录术中丙泊酚和瑞芬太尼用量、术后舒芬太尼补充量，以及术后恶心呕吐、嗜睡、呼吸抑制的发生情况。
结果 术后1 h内和术后1～2 h I组FLACC评分＞3分的例数明显少于S组、S组明显少于C组（P<0.05）。S组和C组舒芬太尼补充量明显多于I组（P＜0.05）。三组术后恶心呕吐、嗜睡和呼吸抑制发生率差异均无统计学意义。
结论 与布洛芬栓比较，布洛芬注射液静脉给药可有效减轻腹腔镜下腹股沟斜疝修补术患儿的术后疼痛，对阿片类药物术后镇痛有很好的辅助作用。 |
| 英文摘要: |
Objective To study the postoperative analgesic effect of ibuprofen injection in children undergoing laparoscopic indirect inguinal hernia repair.
Methods Three hundred children undergoing laparoscopic inguinal hernia repair from May to December 2020, including 92 children with bilateral indirect inguinal hernia and 208 children with unilateral indirect inguinal hernia, 278 males and 22 females, aged 10 months to 4 years, weighing 8.5-22.0 kg, ASA physical status Ⅰ or Ⅱ, were randomly divided into three groups with 100 children in each: ibuprofen injection group (group Ⅰ), ibuprofen suppositories group (group S), and control group (group C). At the beginnning of anesthesia, group I received ibuprofen ivgtt infusion 10 mg/kg, group S received ibuprofen suppositories 5 mg/kg, and group C received the equal dose of normal saline. PCIA was used for postoperative analgesia. When the FLACC scores were more than 3 points, children were given the single dose of sufentanil 0.05-0.1 μg/kg. The FLACC scores within 1, 2, 4, 6, and 8 hours after operation and the occurrence of FLACC scores greater than 3 points were observed and recorded within 1, 1-2, 2-4, 4-6, and 6-8 hours after operation. The intraoperative dose of propofol and remifentani, postoperative sufentanil supplementation were recorded. The incidence of nausea, vomiting, drowsiness and respiratory depression during PCIA were observed.
Results The incidence of FLACC scores greater than 3 points in group I were significantly lower than that in group S within 1 and 1-2 hours after operation (P < 0.05). Compared with group S and group C, the single dose of sufentanil in group I were significantly lower (P < 0.05). There were no statistically significant differences in the incidence of nausea, vomiting, drowsiness and respiratory depression during PCIA.
Conclusion Ibuprofen intravenous injection can effectively relieve the postoperative pain of children undergoing laparoscopic indirect inguinal hernia repair, and has a good auxiliary effect on opioid postoperative analgesia with less adverse reactions. |
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