摘要
目的观察髂腹股沟/髂腹下神经阻滞与对乙酰氨基酚直肠给药用于小儿疝修补手术后镇痛的效果和安全性。方法选取择期行单侧腹股沟斜疝修补术患儿90例,随机分为神经阻滞组、对乙酰氨基酚组和对照组,各30例。各组患儿行基础麻醉后,神经阻滞组行患侧髂腹股沟/髂腹下神经阻滞;对乙酰氨基酚组经肛门塞入直肠对乙酰氨基酚栓剂;对照组未予任何药物镇痛。分别于术后1、3、6、8h进行疼痛评分,由患儿父母评价总体满意度。记录各组镇痛24h内不良反应发生情况。结果神经阻滞组、对乙酰氨基酚组与对照组比较,患儿术后1、3、6h疼痛评分显著降低,总体满意度显著提高。延迟性股神经阻滞在神经阻滞组较对乙酰氨基酚组、对照组发生例数显著增多(F=4.22P<0.05)。结论髂腹股沟/髂腹下神经阻滞、对乙酰氨基酚直肠给药均可用于小儿疝修补手术后镇痛,效果确切、安全。对乙酰氨基酚直肠给药更易被小儿接受,实施方法简便易行。
Objective To compare the efficacy and side effects of ilioinguinal/iliohypogastric nerve blockades and rectal paracetamol after pediatric inguinal hernia repair. Methods Ninety children undergoing half inguinal hernia repair were randomly divided into 3 groups： nerve block group （ n = 30 ） , paracetamol group （ n = 30） and control group （ n = 30 ）. After basal anesthesia, ilioinguinal/iliohypogastric nerve blockades was administed in nerve block group, paracetamol group received rectal paracetamol, control group had not any medication. Every child was oberserved 1,3,6,8 h postoperatively for pain score, overall satisfaction were evaluated by parents, furthermore, evaluation of distress for children such as nausea, vomiting and delayed femoral nerve palsy was made. Results Pain scores were significantly lower in nerve block group and paracetamol group during the postoperative follow - up 1,3 and 6 h. Overall satisfaction in nerve block group and paracetamol group were significantly higher than control group. The incidence of delayed femoral nerve palsy in nerve block group was higher than paracetamol group （ F = 4.22 P 〈 0.05 ）. Conclusions Ilioinguinal/iliohypogastric nerve blockades and rectal paracetamol are both good alternatives for control post - herniorrhaphy pain, the latter are easier and much more acceptable to children.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2008年第23期1824-1825,共2页
Journal of Applied Clinical Pediatrics
基金
浙江省医药卫生科学研究基金项目资助(2004A071)
