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目的探讨小儿骶管复合用药对术后镇痛的影响。方法选取2014年6月至2015年6月在肇庆市高要区人民医院进行手术治疗的患儿84例为研究对象,按入院顺序随机分为观察组和对照组,每组42例。所有患儿采用按1 kg/ml比例配置的1%利多卡因麻醉。观察组患儿在麻醉剂中添加芬太尼,术后进行芬太尼泵注镇痛治疗;对照组患儿的麻醉剂中不添加任何药物。记录两组患儿手术后1、2、4、6、24 h的镇痛及镇静评分、镇痛时间,比较其不良反应发生率。结果观察组患儿的手术时间及术后镇痛时间明显短于对照组,镇静评分明显高于对照组,差异有统计学意义(P<0.05);观察组患儿术后芬太尼泵注镇痛使用0次者多于对照组,使用4次者少于对照组,差异有统计学意义(P<0.05)。观察组患儿的不良反应发生率为4.8%,明显小于对照组不良反应发生率的19.0%,差异有统计学意义(P<0.05)。结论采用1 kg/ml比例配置的1%利多卡因联合芬太尼,术后进行芬太尼泵注镇痛治疗,能有效减轻患儿手术后的镇痛程度,其不良反应发生率明显下降,具有较好的镇痛效果。
Objective To investigate the effect of caudal combined medication on postoperative analgesia in children. Methods From June 2014 to June 2015, 84 cases of children undergoing surgery in Gaoyao District People’s Hospital of Zhaoqing City were selected as study subjects and randomly divided into observation group and control group according to admission sequence, with 42 cases in each group. All children received 1% lidocaine anesthesia at a 1 kg / ml ratio. In the observation group, fentanyl was added to the anesthetic and fentanyl was used for postoperative analgesia. In the control group, no drug was added to the anesthetic. The analgesic and sedation score, analgesia time and the incidence of adverse reactions were recorded at 1, 2, 4, 6, 24 h after operation in both groups. Results The operation time and postoperative analgesia time of the observation group were significantly shorter than those of the control group, sedation score was significantly higher than that of the control group (P <0.05); the fentanyl pump Analgesic use of 0 times more than the control group, the use of 4 times less than the control group, the difference was statistically significant (P <0.05). The incidence of adverse reactions in the observation group was 4.8%, which was significantly lower than that in the control group (19.0%), the difference was statistically significant (P <0.05). Conclusion 1% lidocaine combined with fentanyl in the proportion of 1 kg / ml and postoperative fentanyl pump analgesia can effectively relieve postoperative analgesia in children and the incidence of adverse reactions decreased significantly , Has a good analgesic effect.