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目的评价地佐辛复合氟比洛芬酯应用于小儿腹部手术后镇痛的效果及安全性。方法 60例行腹部手术患儿,按照治疗方法不同随机分为地佐辛+氟比洛芬酯组(D组)和舒芬太尼组(S组),每组30例。手术结束前30 min,D组静脉滴注氟比洛芬酯1 mg/kg,术毕患儿清醒拔管后行静脉镇痛,地佐辛0.5 mg/kg+氟比洛芬酯3 mg/kg+昂丹司琼0.1 mg/kg+0.9%氯化钠注射液至100 ml;S组静脉滴注舒芬太尼0.05μg/kg,舒芬太尼2.5μg/kg+昂丹司琼0.1 mg/kg+0.9%氯化钠注射液至100 ml;两组持续剂量均为2 ml/h,术后镇痛(PCA)为2 ml。记录两组2、6、12、24、48 h的Wong-Baker面部表情量表评分和Ramsay镇静评分,并观察记录两组不良反应发生情况。结果术后48 h内两组各观察点Wong-Baker面部表情量表评分均<4分,Ramsay评分均<3分,比较差异无统计学意义(P>0.05)。两组患儿均没有出现呼吸抑制情况,但S组出现恶心呕吐4例、嗜睡4例明显高于D组的0、1例(P<0.05)。结论地佐辛复合氟比洛芬酯用于小儿腹部手术后镇痛具有安全性较好、效果确切,不良反应少的优点,值得临床推广。
Objective To evaluate the effect and safety of dezocine combined with flurbiprofen axetil in children with postoperative abdominal pain. Methods Sixty children undergoing abdominal surgery were randomly divided into two groups: dezocine + flurbiprofen axetil group (D group) and sufentanil group (S group), with 30 cases in each group. Thirty minutes before the end of surgery, group D was given flurbiprofen axetil 1 mg / kg intravenously, and intravenous analgesia was given after debridement. Dezocine 0.5 mg / kg + flurbiprofen axetil 3 mg / kg + Ondansetron 0.1 mg / kg + 0.9% sodium chloride injection to 100 ml; S group intravenous sufentanil 0.05μg / kg, sufentanil 2.5μg / kg + ondansetron 0.1 mg / kg + 0.9% sodium chloride injection to 100 ml; sustained dose of 2 ml / h, postoperative analgesia (PCA) 2 ml. Two groups of Wong-Baker facial expression score and Ramsay sedation score were recorded at 2, 6, 12, 24 and 48 h after treatment. The occurrence of adverse reactions in the two groups were recorded. Results The scores of Wong-Baker facial expression questionnaire in both groups were all less than 4 points and Ramsay score <3 points within 48 hours after operation. There was no significant difference between the two groups (P> 0.05). No respiratory depression occurred in both groups. However, 4 cases of nausea and vomiting and 4 cases of drowsiness in group S were significantly higher than those in group D (P <0.05). Conclusion Dezocine compound flurbiprofen axetil for pediatric abdominal surgery after analgesia with good safety, exact effect, fewer adverse reactions, is worth clinical promotion.