右美托咪定辅助用于小儿尿道下裂修补术后镇痛的效果观察(1)
摘 要：目的 观察右美托咪定复合芬太尼用于尿道下裂修补术患儿术后镇痛的效果及安全性。方法 選择全麻下择期行尿道下裂修补术的患儿60例，随机分为F组和D组，各30例。F组给予芬太尼0.3 μg/(kg·h)，D组给予右美托咪定0.05 μg/(kg·h)+芬太尼0.2 μg/(kg·h)，所有患者手术结束前30 min，给予芬太尼负荷剂量1 μg/kg。手术结束前即刻连接一次性恒速机械镇痛泵，泵注速率2 ml/h。记录连接镇痛泵后2、4、8、12、24及48 h的Wong-Baker脸谱疼痛评分和Ramsay镇静评分，补救镇痛次数以及术后心动过缓、低血压、恶心呕吐等不良反应发生情况。结果 与F组比较，D组患儿补救镇痛次数、恶心呕吐及躁动发生率降低，患儿2、4、8、12、24及48 h的Wong-Baker脸谱疼痛评分降低、而Ramsay镇静评分增高，差异有统计学意义(P<0.05)，两组患者在镇痛过程中均未出现心动过缓及低血压。结论 右美托咪定辅助用于小儿尿道下裂术后镇痛能提供较好镇痛效果和较佳镇静舒适度，减少不良反应的发生。
, 百拇医药 关键词：右美托咪定；芬太尼；尿道下裂修补术；术后镇痛
中图分类号：R782.05+4 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.23.040
文章编号：1006-1959(2018)23-0139-03
Abstract：Objective To observe the effect and safety of dexmedetomidine combined with fentanyl for postoperative analgesia in children with hypospadias repair. Methods 60 patients with elective hypospadias under general anesthesia were randomly divided into group F and group D，30 cases each. Group F was given fentanyl 0.3 μg/(kg·h)， group D was given dexmedetomidine 0.05 μg/ (kg·h) + fentanyl 0.2 μg/(kg·h)， all patients before the end of surgery 30 min， fentanyl was given a loading dose of 1 μg/kg. A one-time constant-speed mechanical analgesia pump was connected immediately before the end of the operation， and the pumping rate was 2 ml/h. Wong-Baker facial pain score and Ramsay sedation score were recorded at 2， 4， 8， 12， 24， and 48 h after analgesia pump，Remedy the number of analgesic and adverse reactions such as postoperative bradycardia， hypotension， nausea and vomiting. Results Compared with group F， the number of remedies for analgesia， nausea， vomiting， and agitation were lower in group D. The Wong-Baker facial pain scores were lower at 2， 4， 8， 12， 24， and 48 h， and the Ramsay sedation score was lower，the difference was statistically significant (P<0.05). There was no bradycardia or hypotension during the analgesia in both groups. Conclusion Dexmedetomidine can improve the analgesic effect and better sedative comfort after pediatric hypospadias and reduce the incidence of adverse reactions.
, 百拇医药
Key words：Dexmedetomidine；Fentanyl；Repair of Hypospadias；Postoperative analgesia
尿道下裂修补术(repair of hypospadias)常产生剧烈的术后疼痛造成严重应激反应和患儿的烦躁不适，影响患儿预后。传统阿片类镇痛药物副作用较多，限制了其在临床上的大量应用。目前采用多种镇痛药物联合应用，以减少单一镇痛药带来的副作用。其中右美托咪定为高选择性α2受体激动剂具有镇静、镇痛、抗焦虑作用，受到越来越多的关注。然而国内外研究多基于不同类型手术，关于阿片类药物以及右美托咪定的用量亦不尽相同，因此有必要研究右美托咪定辅助用于尿道下裂患儿术后镇痛的效果以及所需药物剂量，以期指导临床。
1资料与方法
1.1一般资料 选择2018年2月～6月苏州大学医学院附属儿童医院收治的择期行全麻下尿道下裂修补术患儿60例，本研究经本院伦理委员会批准。纳入研究的患儿监护人均知情同意并签署知情同意书，排除房室传导阻滞、心脏功能障碍者，过度肥胖者以及手术时间<1 h和>3 h者。采用随机数字表法将患儿分为芬太尼(F组)和右美托咪定组(D组)，每组30例。F组患儿：年龄1～14岁，平均年龄(3.47±2.97)岁，体重8.5～60 kg，平均体重(16.71±10.16)kg。D组患儿：年龄1～12岁，平均年龄(4.20±2.93)岁，体重10～42 kg，平均体重(17.10±9.02)kg。(16.71±10.16)kg。, 百拇医药(涂兆珍 韩学敏 张帆)
, 百拇医药 关键词：右美托咪定；芬太尼；尿道下裂修补术；术后镇痛
中图分类号：R782.05+4 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.23.040
文章编号：1006-1959(2018)23-0139-03
Abstract：Objective To observe the effect and safety of dexmedetomidine combined with fentanyl for postoperative analgesia in children with hypospadias repair. Methods 60 patients with elective hypospadias under general anesthesia were randomly divided into group F and group D，30 cases each. Group F was given fentanyl 0.3 μg/(kg·h)， group D was given dexmedetomidine 0.05 μg/ (kg·h) + fentanyl 0.2 μg/(kg·h)， all patients before the end of surgery 30 min， fentanyl was given a loading dose of 1 μg/kg. A one-time constant-speed mechanical analgesia pump was connected immediately before the end of the operation， and the pumping rate was 2 ml/h. Wong-Baker facial pain score and Ramsay sedation score were recorded at 2， 4， 8， 12， 24， and 48 h after analgesia pump，Remedy the number of analgesic and adverse reactions such as postoperative bradycardia， hypotension， nausea and vomiting. Results Compared with group F， the number of remedies for analgesia， nausea， vomiting， and agitation were lower in group D. The Wong-Baker facial pain scores were lower at 2， 4， 8， 12， 24， and 48 h， and the Ramsay sedation score was lower，the difference was statistically significant (P<0.05). There was no bradycardia or hypotension during the analgesia in both groups. Conclusion Dexmedetomidine can improve the analgesic effect and better sedative comfort after pediatric hypospadias and reduce the incidence of adverse reactions.
, 百拇医药
Key words：Dexmedetomidine；Fentanyl；Repair of Hypospadias；Postoperative analgesia
尿道下裂修补术(repair of hypospadias)常产生剧烈的术后疼痛造成严重应激反应和患儿的烦躁不适，影响患儿预后。传统阿片类镇痛药物副作用较多，限制了其在临床上的大量应用。目前采用多种镇痛药物联合应用，以减少单一镇痛药带来的副作用。其中右美托咪定为高选择性α2受体激动剂具有镇静、镇痛、抗焦虑作用，受到越来越多的关注。然而国内外研究多基于不同类型手术，关于阿片类药物以及右美托咪定的用量亦不尽相同，因此有必要研究右美托咪定辅助用于尿道下裂患儿术后镇痛的效果以及所需药物剂量，以期指导临床。
1资料与方法
1.1一般资料 选择2018年2月～6月苏州大学医学院附属儿童医院收治的择期行全麻下尿道下裂修补术患儿60例，本研究经本院伦理委员会批准。纳入研究的患儿监护人均知情同意并签署知情同意书，排除房室传导阻滞、心脏功能障碍者，过度肥胖者以及手术时间<1 h和>3 h者。采用随机数字表法将患儿分为芬太尼(F组)和右美托咪定组(D组)，每组30例。F组患儿：年龄1～14岁，平均年龄(3.47±2.97)岁，体重8.5～60 kg，平均体重(16.71±10.16)kg。D组患儿：年龄1～12岁，平均年龄(4.20±2.93)岁，体重10～42 kg，平均体重(17.10±9.02)kg。(16.71±10.16)kg。, 百拇医药(涂兆珍 韩学敏 张帆)