摘要
目的:分析右美托咪定与吗啡麻醉对小儿隐匿性阴茎延长术术后镇痛的影响。方法:选择2018年9月—2021年4月在厦门大学附属妇女儿童医院诊治的隐匿性阴茎患儿102例,根据随机信封抽签1∶1原则将患儿分为吗啡组与右美托咪定组,各51例。所有患儿均给予阴茎延长术治疗与骶管麻醉,右美托咪定组采用罗哌卡因和右美托咪定进行骶管麻醉,吗啡组采用罗哌卡因和吗啡进行骶管麻醉,比较两组围术期指标、疼痛程度、并发症发生情况及满意度。结果:两组手术时间、术中出血量、液体补充量、麻醉持续时间比较,差异无统计学意义(P>0.05);右美托咪定组术后2 h、术后4 h、术后8 h、术后24 h的疼痛VAS评分低于对照组(P<0.05);两组术后2 h、术后4 h、术后8 h、术后24 h的镇静Ramsay评分比较,差异无统计学意义(P>0.05);右美托咪定组并发症发生率为3.9%,低于吗啡组的27.5%(P<0.05);右美托咪定组家长术后3个月对于阴茎外观的总满意度为100%,高于对照组的88.2%(P<0.05)。结论:相对于吗啡,右美托咪定骶管麻醉可提高小儿隐匿性阴茎延长术术后镇痛效果,减少术后并发症的发生,改善术后阴茎外观。
Objective:To investigate the effects of dexmedetomidine and morphine anesthesia on postoperative analgesia of concealed penile lengthening in children.Methods:A total of 102 children with concealed penis admitted to Women and Children’s Hospital Affiliated to Xiamen University from September 2018 to April 2021 were selected and divided into morphine group and dexmedetomidine group according to the principle of random envelope drawing 1∶1,with 51 cases in each group.All patients were treated with penile lengthening and sacral anesthesia.The dexmedetomidine group was treated with ropivacaine and dexmedetomidine for sacral anesthesia,and the morphine group was treated with ropivacaine and morphine for sacral anesthesia.Perioperative indicators,pain degree,complications and satisfaction were compared between the two groups.Results:There were no statistically significant difference in operation time,intraoperative blood loss,fluid supplementation,duration of anesthesia compared between the two groups(P>0.05).The pain VAS scores of the dexmedetomidine group at 2h,4h,8h,and 24h after surgery were lower than those of the control group(P<0.05).There were no significant difference in sedation Ramsay scores between the two groups at 2h,4h,8h,and 24h after surgery compared between the two groups(P>0.05).The incidence of complications in the dexmedetomidine group were 3.9%,which were lower than 27.5%in the morphine group at 3d after surgery(P<0.05).The total satisfaction with the appearance of the penis in the parents in the dexmedetomidine group at 3 months after surgery were 100.0%,which were higher than 88.2%in the control group(P<0.05).Conclusion:Compares with morphine,the application of dexmedetomidine sacral anesthesia in pediatric concealed penile lengthening surgery for postoperative analgesia can improve the analgesic effect,reduce the occurrence of postoperative complications,and improve the appearance of the penis after the operation.
作者
林鹏
梁小玲
张运宏
王永洪
贾俊香
LIN Peng;LIANG Xiaoling;ZHANG Yunhong;WANG Yonghong;JIA Junxiang(Anesthesiology Department,Women and Children,s Hospital,School of Medicine,Xiamen University,Xiamen 351000,Fujian,China)
出处
《中国药物滥用防治杂志》
CAS
2022年第5期615-619,共5页
Chinese Journal of Drug Abuse Prevention and Treatment
基金
福建省卫计委中青年骨干人才培养项目(编号:2018—ZQN—86)。
关键词
吗啡
右美托咪定
隐匿性阴茎
阴茎延长
镇痛
镇静
Morphine
Dexmedetomidine
Concealed penis
Penis lengthening
Analgesia
Sedation
