Meignier M, Zaouter M, Ricard P, Charles-Guillard S, Heloury Y, Rogez J M, Pannier M
Service de Chirurgie Infantile, CHR de Nantes.
Chir Pediatr. 1990;31(6):341-4.
Operative and postoperative analgesia has become in a few years a major concern for pediatric anesthesiologists. The fact that pain can have dramatic metabolic and hemodynamic consequences has been well documented. This study shows the activity in our department in the field of analgesia during 1989. 82% of the 2,675 children having undergone surgery have received analgesia during the operative period either by the way of an i.v. narcotic or an regional block. No morbidity or mortality resulted from these techniques during the operative period. When a regional block was prolonged by the mean of a catheter, there were no major complication (2 seizures). The use of oral, rectal and i.v. analgesics follows the classic recommendations. Morphine by all routes of administration is used increasingly in our department. Two moderate respiratory depressions occurred in 1989 due to error in dosage with no consequence for the child. The authors underline the importance of well established protocols which have been discussed and approved by all, the importance of emergency procedures and treatment, which only can guaranteed the necessary safety.
手术及术后镇痛在几年内已成为儿科麻醉医生的主要关注点。疼痛会产生显著的代谢和血流动力学后果这一事实已有充分记录。本研究展示了我们科室在1989年镇痛领域的工作情况。2675名接受手术的儿童中，82%在手术期间通过静脉注射麻醉剂或区域阻滞的方式接受了镇痛。这些技术在手术期间未导致任何发病率或死亡率。当通过导管延长区域阻滞时，未出现重大并发症（2例癫痫发作）。口服、直肠及静脉注射镇痛药的使用遵循经典建议。我们科室越来越多地通过各种给药途径使用吗啡。1989年因剂量错误发生了两例中度呼吸抑制，但对患儿未造成后果。作者强调了已得到所有人讨论并批准的完善方案的重要性，以及紧急程序和治疗的重要性，只有这样才能确保必要的安全性。
