Zhang Fuzhou,Zheng Tiehua,Ren Yi,et al.Application of multimode analgesia based predominantly upon single thoracic epidural block during pediatric Nuss procedure[J].Journal of Clinical Pediatric Surgery,,22():751-756.[doi:10.3760/cma.j.cn101785-202206020-010]
Application of multimode analgesia based predominantly upon single thoracic epidural block during pediatric Nuss procedure
- Keywords:
- Funnel Chest; Orthopedic Procedures; Anesthesia; Epidural; Analgesia; Child
- Abstract:
- Objective To evaluate the efficacy of multimode analgesia based predominantly upon single thoracic epidural block during pediatric Nuss procedure.Methods From December 2020 to September 2021, 42 children underwent Nuss procedure.Random number table method was employed for assigning them into two groups of single thoracic epidural block plus general anesthesia (T) and general anesthesia (G).Group T underwent thoracic epidural block in a lateral position after tracheal intubation induced by general anesthesia.Group G was maintained by intravenous anesthesia after endotracheal intubation.After operation, both groups underwent electronic pump intravenous analgesia (self-control + continuous administration mode).Operative duration, anesthetic time, intraoperative propofol dose, sufentanil dose, remifentanil dose and hemodynamic changes were recorded.The resting pain scores at 1/6/12/24/48h and the timepoints of PCIA at 0-1 h, 1-6 h, 6-12 h, 12-24 h and 24-48 h post-operation were recorded.Postoperative nausea, vomiting, constipation, pain and other complications were recorded.Complications related to epidural puncture were recorded.Results Intraoperative dose of remifentanil in group T was less than that in group G(P<0.05);The resting pain scores of group T were lower than those of group G at 1/6/12 h post-operation (P<0.05).No significant inter-group difference existed in pain scores at 24/48 h post-operation (P>0.05).The frequency of patient controlled intravenous analgesia (PCIA) at each timepoint in group T was less than that in group G(P<0.05).The number of children with postoperative remedial analgesia was less than G(P<0.05) while the number of children with nausea was more than G(P<0.05).No statistical difference existed in the bout of vomiting or constipation (P>0.05).Epidural puncture was successful in T group without puncture related complications.Conclusion In children undergoing Nuss surgery, multi-mode analgesia based predominantly upon single thoracic epidural block may reduce the application of intravenous opioids.Its early postoperative analgesic effect is better than that of intravenous analgesia pump alone, thus improving the comfort level of children.
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Memo
收稿日期:2022-06-08。
基金项目:吴阶平医学基金会临床科研专项资助基金（320.6750.19089-102）
通讯作者:张建敏,Email:zjm428@sina.com