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目的:观察氟比洛芬酯注射液用于小儿包皮环切术后的镇痛效果及安全性。方法:择期行包皮环切术小儿120例,随机分为4组。A组为对照组,于手术结束后在环切伤口处喷洒生理盐水3 ml;B组为超前镇痛组,于手术开始前5 min缓慢静脉注射氟比洛芬酯脂1 mg.kg-1,并于手术结束后在环切伤口处喷洒生理盐水3 ml;C组为术后镇痛组,于手术结束时缓慢静脉注射氟比洛芬酯脂1 mg.kg-1,并于手术结束后在环切伤口处喷洒生理盐水3 ml;D组为利多卡因组,于手术结束后在环切伤口处喷洒2%利多卡因3 ml。观察术后患儿麻醉后复苏评分、镇静评分、镇痛评分,记录苏醒时间、首次排尿时间和副作用发生情况。结果:4组患儿麻醉后复苏评分、镇静评分、苏醒时间、副作用的比较差异均无统计学意义(P>0.05)。B组、C组各时间点疼痛评分低于A组,B组也低于C组(P<0.05);而D组与B组0.5、1 h疼痛评分比较差异无统计性(P>0.05),其余时间点比较差异有统计学意义(P<0.05)。结论:氟比洛芬酯静脉使用能有效减轻包皮环切术后患儿急性疼痛,超前使用效果更佳,且无明显不良反应,可安全用于小儿术后镇痛。局部使用利多卡因能起到短效镇痛作用。
Objective: To observe the analgesic effect and safety of flurbiprofen axetil injection after circumcision in children. Methods: Elective circumcision in children 120 cases were randomly divided into 4 groups. Group A was the control group. After the operation, 3 ml of saline was sprayed on the cut wound. Group B was an anterior analgesia group, and flurbiprofen axetil 1 mg.kg-1 was slowly injected intravenously 5 minutes before the operation , And 3 ml of normal saline was sprayed on the cut wound at the end of the operation. Group C was postoperative analgesia group, and flurbiprofen ester 1 mg.kg-1 was slowly injected intravenously at the end of the operation. At the end of the operation After the ring cut wounds were sprayed with saline 3 ml; Group D was lidocaine group, and 2 ml of lidocaine was sprayed 3 ml after wound closure at the end of the operation. Postoperative anesthesia recovery score, sedation score, analgesic score, recorded wake time, first urination time and side effects were observed. Results: There was no significant difference in resuscitation score, sedation score, recovery time and side effects between the four groups (P> 0.05). Pain score in group B and group C at each time point was lower than that in group A, and in group B was also lower than that in group C (P <0.05). There was no significant difference in pain score between 0.5 and 1 h in group D and group B (P> 0.05) , The rest of the time point difference was statistically significant (P <0.05). Conclusion: The use of flurbiprofen axetil can effectively relieve the acute pain in children after circumcision, with better effect in advance and no obvious adverse reactions, which can be safely used in pediatric postoperative analgesia. Local use of lidocaine can play a short-acting analgesic effect.