布洛芬超前镇痛在儿童膝关节镜手术中的应用研究
- 摘要:
- 目的 研究布洛芬超前镇痛对儿童膝关节镜手术后疼痛、镇痛药物的使用、不良反应及与外周血前列腺素E2 (PGE2)的影响。 方法 将60例膝关节镜手术患儿随机分为观察组和对照组,观察组术前48 h、24 h给予布洛芬10 mg,对照组术前48 h、24 h给予口服安慰剂(复合维生素)。术后12 h、24 h、36 h、48 h、72 h两组均予布洛芬300 mg,并用视觉模拟评分法(VAS)评价术后镇痛效果,同时调查患者镇痛满意度(SD)与睡眠满意度(SS),记录额外镇痛药物的援助情况和不良反应。两组患儿于手术结束时及术后24 h检测PGE2的浓度。 结果 观察组术后2 h、4 h、8 h、12 h的VAS评分明显低于对照组(P < 0.05)。观察组镇痛满意度(SD)与睡眠满意度(SS)显著高于对照组(P < 0.01),而观察组额外镇痛药的使用和不良反应的发生都少于对照组。术后24 h血清中PGE2浓度观察组也明显低于对照组(P < 0.01)。 结论 布洛芬超前镇痛用于儿童膝关节镜手术,能有效缓解术后疼痛,改善睡眠状况,减少术后镇痛药物的使用,且无明显不良反应。
参考文献/References:
1 Narsinghani U,Anand KJ.Developmental Neurobiology of Pain in Neonatal Pats[J].Lab Anim(NY),2009,29(9):27-39.
2 曾睿峰,何伟,王建光等.氟比洛芬酯超前镇痛在小儿斜疝手术中的应用[J].现代实用医学,2008,(12):976-977.
3 Kaye AD,Baluch A,Kaye AJ,Ralf G,Lubarsky D. Pharmacology of cyclooxygenase-2 inhibitors and preemptive analgesia in acute pain management[J].Curr Opin Anaesthesiol,2008;21 (4):439-445.
4 Reuben SS,Buvanendran A.Preventing the development of chronic pain after orthopaedic surgery with preventive multimodal analgesic techniques[J].J Bone Joint Surg Am, 2007,89 (6): 1343-1358.
5 Bourne MH.Analgesics for orthopedic postoperative pain[J]. Am J Orthop,2004,33(3): 128-135.
6 Clark E,Plint AC,Correll R,et al.A randomized, controlled trial of acetaminophen, ibuprofen, and codeine for acute pain relief in children with musculoskeletal trauma[J].Pediatrics,2007,119(3):460-467.
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备注/Memo
1,湖南长沙宁乡县第三人民医院骨科(416000);2,湖南长沙中南大学湘雅二医院骨科(410011)