多模式术后镇痛在小儿腹腔镜手术中的应用
张永刚
（陕西省宝鸡市妇幼保健院麻醉科，陕西 宝鸡，721000）
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摘要：
目的 观察多模式镇痛在小儿腹腔镜手术术后镇痛的效果。方法 将全麻下腹腔镜疝囊高位结扎手术患儿80例随机分为对照组和观察组，各40例。对照组采用常规镇痛，观察组采用多模式镇痛，比较两组患儿的麻醉效果及不良反应发生情况。结果 观察组在T2、T3、T4、T5 时间点的MAP、HR 显著低于对照组（P<0.05），而SpO2、RR 与对照组比较，无显著差异（P>0.05）；术后1、4、8、12 h，观察组VAS镇痛评分明显低于对照组，Ramsay 镇静评分明显高于对照组（P<0.05）；两组患儿的不良反应无无显著差异（P>0.05）。结论 多模式镇痛方法在小儿腹腔镜手术术后可获得有效的镇痛、镇静效果及安全性。
关键词：多模式镇痛；腹腔镜手术；VAS 镇痛评分
中图分类号：R614 文献标志码：A文章编号：2096-1413(2017)21-0054-02
Application of multimodal postoperative analgesia in children with laparoscopic surgery
ZHANG Yong-gang
(Department of Anesthesiology, Baoji Maternity and Child Health Hospital, Baoji 721000, China)
ABSTRACT: Objective To observe the analgesic effect of multimodal analgesia in pediatric laparoscopic surgery. Methods Eighty cases of children with laparoscopic hernia sac high ligation under general anesthesia were randomly divided into control group and observation group, with 40 cases in each group. The control group received routine analgesia, and the observation group was treat with multimodal analgesia. The anesthesia effect and incidence of adverse reaction of the two groups were compared. Results The MAP and HR in the observation group at T2、T3、T4、T5 after surgery were significantly lower than those in the control group (P<0.05), and there were no significant differences in the SpO2 and RR between the two groups (P>0.05). After surgery 1, 4, 8, 12 h, the VAS pain score in the observation group were significantly lower than those in the control group, and the Ramsay sedation scores were significantly higher than the control group (P<0.05). There was no significant difference in adverse reaction between the two groups (P>0.05). Conclusion Multimodal analgesia can achieve significant analgesia effect in pediatric laparoscopic surgery, sedation and safety.
KEYWORDS: multimodal analgesia; laparoscopic surgery; VAS pain score
参考文献：
[1] 邬娇,郭曲练.儿童术后镇痛的现状及进展[J].实用疼痛学杂志,2007,3(5):373-378.
[2] 董秀丽,覃倩,李燕华,等.术后疼痛患儿镇痛药物使用研究现状[J].护理学杂志,2014,29(10):20-22.
[3] 郭一闽,王忱.小儿术后镇痛的现状、评估及发展趋势[J].广东医学,2008,29(2):338-340.
[4] 王英伟.平衡镇痛与多模式镇痛在术后疼痛治疗中的价值[J].国际麻醉学与复苏杂志,1995,16(1):43-46.
[5] 袁淑珍.多模式镇痛在髋膝关节置换术后患者护理康复中的应用[J].医疗装备,2016,29(19):173-174.
[6] 黄俊伟,伍淑韫,曾彩红,等.儿童腹腔镜术后多模式镇痛的应用[J].广东医学,2013,34(18):2840-2842.
[7] VERGHESE ST,HANNALLAH RS.Postoperative pain management in children[J].Anesthesiol Clin North America,2005,23(1):163-184.