丁哌卡因用于小儿硬膜外术后镇痛

目的比较0.15%丁哌卡因与0.15%丁哌卡因+芬太尼用于小儿硬膜外术后镇痛有效性、安全性。方法ASAⅠ～Ⅱ级择期或急诊手术患儿35例,行硬膜外术后镇痛,随机分为A、B两组,A组19例,采用0.15%丁哌卡因,B组16例,采用0.15%丁哌卡因十芬太尼(2μg/ml)。比较两种配方的镇痛效果、用药量、不良反应及镇静评分。结果两种方法镇痛效果、镇静评分相同(P>0.05),而A组用药量多于B组(P<0.01);B组有恶心呕吐、尿潴留的不良反应,A组无恶心呕吐、尿潴留的不良反应;两组均有下肢麻木的不良反应,A、B两组无显著差异。结论小儿硬膜外术后镇痛,0.15%丁哌卡因优于0.15%丁哌卡因+芬太尼。

BUPIVACAINE USED FOR PEDIATRIC POSTOPERATIVE EPIDURAL ANALGESIA

Objective To compare the effect and safety of 0.15% bupivacine with or without fentanyl administered epidurally for postoperative analgesia. Methods Thirty-five pediatric patients, ASA class Ⅰ～Ⅱ, received selective or emergent surgery below low abdominal level, were randomly divided into group A (n=19)and group B (n=16). Epidural anesthesia was selected. After operation, 0.15% bupivacaine was infused epidurally in group A and 0.15% bupivacaine with fentanyl (100 ml containing fentanyl 0.2 mgoup B. The analgesia effects,anaesthetic doses, side effects and Ramsay scores were recorded. Results Analgesia effects and Ramsay scores were the same in both groups (P>0.05). Anaesthetic doses in group A were more than in group B (P<0.01). There were nausea,vomit and urinary retension in group B, but none in group A (P<0.05). Conclusion When used for pediatric postoperative epidural analgesia, 0.15% Bupivacaine is better than 0.15% Bupivacaine with fentanyl.