布比卡因与利多卡因用于新生儿包皮环切术的镇痛效果比较
Bupivacaine versus lidocaine analgesia for neonatal circumcision.
作者信息
Stolik-Dollberg Orit C, Dollberg Shaul
机构信息
Department of Anesthesiology, Sheba Medical Center, Tel Hashomer, Israel.
出版信息
BMC Pediatr. 2005 May 22;5(1):12. doi: 10.1186/1471-2431-5-12.
BACKGROUND
Analgesia for neonatal circumcision was recently advocated for every male infant, and its use is considered essential by the American Academy of Pediatrics. We compared the post-operative analgesic quality of bupivacaine to that of lidocaine for achieving dorsal penile nerve block (DPNB) when performing neonatal circumcision.
METHODS
Data were obtained from 38 neonates following neonatal circumcision. The infants had received DPNB analgesia with either lidocaine or bupivacaine. The outcome variable was the administration by the parents of acetaminophen during the ensuing 24 hours.
RESULTS
Seventeen infants received lidocaine and 19 received bupivacaine DPNB. Ten infants in the lidocaine group (59%) were given acetaminophen following circumcision compared to only 3 (16%) in the bupivacaine group (P < 0.01). Regression analysis showed that the only significant variable associated with the need for acetaminophen was the use of lidocaine (R2 = 20.6; P = 0.006).
CONCLUSION
DPNB with bupivacaine for neonatal circumcision apparently confers better analgesia than lidocaine as judged by the requirement of acetaminophen over the ensuing 24-hour period.
背景
近期提倡对每个男婴进行新生儿包皮环切术镇痛，美国儿科学会认为其使用至关重要。我们比较了在进行新生儿包皮环切术时，布比卡因与利多卡因用于阴茎背神经阻滞（DPNB）的术后镇痛质量。
方法
数据来自38例新生儿包皮环切术后的患儿。这些婴儿接受了利多卡因或布比卡因的DPNB镇痛。观察指标是术后24小时内家长给予对乙酰氨基酚的情况。
结果
17例婴儿接受了利多卡因DPNB，19例接受了布比卡因DPNB。利多卡因组有10例婴儿（59%）在包皮环切术后给予了对乙酰氨基酚，而布比卡因组只有3例（16%）（P < 0.01）。回归分析表明，与需要使用对乙酰氨基酚相关的唯一显著变量是利多卡因的使用（R2 = 20.6；P = 0.006）。
结论
根据术后24小时内对乙酰氨基酚的使用需求判断，布比卡因用于新生儿包皮环切术的DPNB镇痛效果明显优于利多卡因。
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