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髂筋膜间隙阻滞用于小儿发育性髋脱位术后的早期镇痛 被引量:9

Effect of fascia illiaca compartment block with ropivacaine on early analgesia in children with development dislocation of the hip received salter arthroplasty treatment
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摘要 目的观察髂筋膜间隙阻滞用于小儿发育性髋脱位术后早期镇痛的效果和安全性。方法选取2010年4月至10月北京积水潭医院择期行单侧发育性髋脱位手术的患儿64例,经医院伦理委员会通过,随机数字表随机分为神经阻滞组(F组)和对照组(C组)。全身麻醉诱导后,F组用0.2%罗哌卡因行患侧髂筋膜间隙阻滞;C组用生理盐水行患侧髂筋膜间隙阻滞。术中以静吸复合维持麻醉,分别记录术中及术后恢复室芬太尼用量,术后1、4、24h疼痛行为学评分,患儿家长满意度,以及不良反应发生情况。结果与C组比较,F组术中芬太尼用量显著减少[(66±21)ug减至(51±13)ug,P〈0.05],术后1、4、24h疼痛行为学评分显著降低(分别为2.3±0.8,2.0±0.6,1.2±0.4,P〈0.05),家长满意度显著提高(3.4±0.6升至4.9±0.3,P〈0.05),不良反应差异无统计学意义。结论0.2%罗哌卡因行单次髂筋膜间隙阻滞用于小儿发育性髋脱位手术后早期镇痛,安全性好,镇痛效果确切持久,实施方法简便易行。 Objective To observe the efficacy and safety of fascia illiaca compartment block (FICB) with 0. 2% ropivacaine in the early analgesia of children with development dislocation of the hip (DDH) undergoing Salter arthroplasty. Methods Approved by the hospital ethics committee, a total of 64 DDH children were divided randomly into 2 groups: group F (FICB with ropivacaine 0. 2% , 1 mL/kg, max. 30 ml) and group C (FICB with 0. 9% normal saline 1 ml/kg, max. 30 ml). The intra-operative doses of fentanyl, PACU (post-anesthesia care unit), CRIES pain score at 1, 4 and 24 h postoperatively, patient satisfaction score and side effects were recorded. Results The intra-operative doses of fentanyl and PACU were lower. Pain scores at 1, 4 and 24 h postoperatively were lower. And the patient satisfaction score was significantly higher in the FICB group. Conclusion The administration of ropivacaine (0. 2% ) for FICB in the early analgesia of DDH children has the advantages of safety, precision, long-lasting and convenience.
出处 《中华医学杂志》 CAS CSCD 北大核心 2011年第37期2638-2640,共3页 National Medical Journal of China
关键词 髋脱位 先天性 麻醉药 局部 镇痛 罗哌卡因 Hip dislocation,eongenical Anesthetics,local Analgesia Ropivacaine
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参考文献5

  • 1Kim HS, Kim CS, Kim SD, et al. Fascia iliaca compartment block reduces emergence agitation by providing effective analgesic properties in children. J Clin Anesth, 2011, 23:119-123.
  • 2Lako SJ, Steegers MA, van Egmond J, et al. Incisional continuous fascia iliaca block provides more effective pain relief and fewer side effects than opioids after pelvic osteotomy in children. Anesth Analg, 2009, 100:1799-1803.
  • 3Lopez S, Gros T, Bernard N, et al. Fascia iliaca compart ment block for femoral bone fracturesin p rehospital care. Reg Anesth Pain Med, 2003, 28: 203-207.
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同被引文献71

  • 1王晓林,张大志,王庚.不同浓度罗哌卡因用于小儿髂筋膜腔隙阻滞的研究[J].中华临床医师杂志(电子版),2011,5(9):2602-2605. 被引量:8
  • 2Shah RD, Suresh S. Applications of regional anaesthesia in paediatrics [J].Br J Anaesth,2013,lll(Suppll) :i114-124.
  • 3Dalens B, Vanneuville G, Tanguy A. Comparison of the fascia iliaca compartment block with the 3-in-1 block in children [J].Anesth Analg,1989,69(6) :705-713.
  • 4Paut 0, Sallabery M, Schreiber-Deturmeny E, et a1. Continuous fascia iliaca compartment block in children: a prospective evaluation of plasma bupivacaine concentrations, pain scores, and side effects [J].Anesth Analg,2001,92(5) :1159-1163.
  • 5Lako SJ, Steegers MA, Van Egmond J, et a1. Incisional continuous fascia iliaca block provides more effective pain relief and fewer side effects than opioids after pelvic osteotomy in children [J]. Anesth Analg ,2009 ,109( 6) : 1799-1803.
  • 6Suresh S I , Sawardekar A2 , Shah R2. Ultrasound for regional anesthesia in children[J]. Anesthesiol Clin,2014,32(1) :263-279.
  • 7Dolan J , Williams A, Mumey E, et al, Ultrasound guided fascia iliaca block: a comparison with the loss of resistance technique [J]. Reg Anesth Pain Med,2008,33(6) :526-53l.
  • 8Miller BR. Ultrasound-guided fascia iliaca compartment block in pediatric patients using a long-axis, in-plane needle technique: a report of three cases[I]. Paediatr Anaesth,2011,21(l2) :1261-1264.
  • 9Paut 0, Schreiber E, Lacroix F, et a1. High plasma ropivacaine concentrations after fascia iliaca compartment block in children [J].Br J Anaesth,2004 ,92(3) :416-418.
  • 10Ecoffey C. Safety in pediatric regional anesthesia [J]. Paediatr Anaesth ,2012 ,22(1) :25-30.

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