张彬^1,,
胡卫东¹,
赵献亮¹,
王君霞^2,,
1. 山东大学附属儿童医院 麻醉科，山东 济南 250000
2. 山东第一医科大学第一附属医院 儿科，山东 济南 250000

基金项目: 济南市卫生健康委员会科技计划项目(2020-3-44)


详细信息 作者简介: 张 彬（1980-），男，副主任医师。E-mail：qletyymzk@sina.com




通讯作者: 王君霞，副主任医师。E-mail：495435313@qq.com 中图分类号: R726.14


摘要:目的观察骶管阻滞时不同浓度的罗哌卡因对学龄期儿童包皮商环环切术的术中镇痛效果及术后恢复的影响。方法选取90例ASAⅠ～Ⅱ，年龄6～12岁，骶管阻滞下择期行包皮环切术的患儿，依据罗哌卡因的浓度不同，分为R0.15组、R0.2组和R0.25组，每组30例。各组分别注射0.15%、0.2%和0.25%浓度的罗哌卡因0.5 mL/kg。比较各组患儿骶管阻滞的术中镇痛效果、术后镇痛持续时间、下肢麻木持续时间、首次排尿时间、患儿术后的疼痛情况及不良反应。结果R0.25组骶管阻滞术中充分镇痛的比例为93.3%，显著高于R0.15组66.7%和R0.2组76.7%（P＜0.05）。R0.25组术后镇痛持续时间为（247.82±74.86）min，长于R0.15组的（185.58±25.59）min（P＜0.05），与R0.2组（204.00±28.08）min相比，差异无统计学意义（P＞0.05）。患儿下肢麻木时间、首次排尿时间、术后疼痛评分、镇痛干预的人数，以及不良反应发生率差异均无统计学意义（P＞0.05）。结论骶管阻滞应用0.25%浓度的罗哌卡因可为包皮商环环切术的学龄期患儿提供充分的术中镇痛，延长术后镇痛持续时间，不增加恢复时间。
关键词: 罗哌卡因/
骶管阻滞/
包皮环切术/
学龄期儿童/
商环


Abstract:ObjectiveTo study the effect of different concentrations of ropivacaine on the intraoperative analgesia and postoperative recovery of school-age children undergoing shang ring circumcision during caudal block.MethodsA total of 90 children with ASAⅠ - Ⅱ, aged 6-12 years, who underwent elective circumcision under caudal block, were selected and randomly divided into R0.15 group, R0.2 group and R0.25 group, each group was injected with 0.15%, 0.2% and 0.25% concentration of ropivacaine 0.5 mL/kg. The intraoperative analgesic effect, duration of postoperative analgesia, duration of lower limb numbness, first urination time, postoperative pain and adverse effects of children in each group were compared.ResultsThe proportion of adequate intraoperative analgesia during caudal block in R0.25 group was 93.3%, which was significantly higher than that in R0.15 group (66.7%) and R0.2 group (76.7%) (P＜0.05). The duration of postoperative analgesia in the R0.25 group was (247.82±74.86) min, which was longer than that in the R0.15 group [(185.58±25.59) min,P＜0.05], and there was no significant difference compared with the R0.2 group [(204.00±28.08) min,P＞0.05)]. There were no significant differences in the duration of lower limb numbness, time of first urination, postoperative pain score, the number of analgesic interventions, and the incidence of adverse reactions among the groups (P＞0.05).ConclusionThe application of 0.25% ropivacaine for caudal block can provide adequate intraoperative analgesia for shang ring circumcision in school-age children, can extend the duration of postoperative analgesia, and doesn't increase the recovery time.
Keywords:ropivacaine/
caudal block/
circumcision/
school-age children/
shang ring

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