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髂筋膜间隙阻滞通过提供有效的镇痛作用减少儿童术后躁动。

Fascia iliaca compartment block reduces emergence agitation by providing effective analgesic properties in children.

机构信息

Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul 110-744, Korea.

出版信息

J Clin Anesth. 2011 Mar;23(2):119-23. doi: 10.1016/j.jclinane.2010.08.007.

Abstract

STUDY OBJECTIVE

To determine whether fascia iliaca compartment block (FICB) reduces emergence agitation.

DESIGN

Prospective, randomized, blinded clinical trial.

SETTING

Operating room and Postanesthesia Care Unit (PACU) of a university hospital.

PATIENTS

64 ASA physical status 1 and 2 pediatric patients aged three to 7 years, scheduled for orthopedic surgery involving the anterior or lateral thigh.

INTERVENTIONS

Patients enrolled in the FICB group received FICB immediately after the operation, while control group patients received intravenous (IV) patient/parent-controlled analgesia (PCA) with fentanyl.

MEASUREMENTS

Severity of agitation and pain were evaluated using the Pediatric Agitation and Emergence Delirium (PAED) scale and the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS). Data were collected at 10-minute intervals in the PACU. The results were analyzed using the t-test.

MAIN RESULTS

PAED scores in the FICB group were significantly lower than those of the control group on arrival at the PACU (7.3 ± 2.9 vs 10.4 ± 3.2, P < 0.001). The FICB group also had significantly lower CHEOPS pain scores than the control group, both on arrival at the PACU and 10 minutes after arrival (6.4 ± 1.5 vs 10.4 ± 1.8, P < 0.001 and 6.7 ± 1.6 vs 8.0 ± 1.4, P = 0.009, respectively).

CONCLUSION

In children having surgery on the thigh, FICB effectively reduced the severity of emergence agitation and postoperative pain during the immediate postoperative period.

摘要

研究目的

确定股外侧肌间隔阻滞(FICB)是否能减少术后躁动。

设计

前瞻性、随机、盲法临床试验。

设置

大学医院手术室和麻醉后恢复室(PACU)。

患者

64 例 ASA 分级为 1 级和 2 级的 3 至 7 岁小儿患者,拟行涉及前侧或外侧大腿的骨科手术。

干预

FICB 组患者在手术后立即接受 FICB,而对照组患者接受芬太尼静脉(IV)患者/家长自控镇痛(PCA)。

测量

采用儿科躁动和苏醒期谵妄(PAED)量表和安大略省儿童医院疼痛量表(CHEOPS)评估躁动和疼痛的严重程度。在 PACU 中,每 10 分钟收集一次数据。使用 t 检验分析结果。

主要结果

PACU 到达时,FICB 组的 PAED 评分明显低于对照组(7.3 ± 2.9 比 10.4 ± 3.2,P < 0.001)。FICB 组在 PACU 到达时和到达后 10 分钟时的 CHEOPS 疼痛评分也明显低于对照组(6.4 ± 1.5 比 10.4 ± 1.8,P < 0.001 和 6.7 ± 1.6 比 8.0 ± 1.4,P = 0.009)。

结论

在大腿手术的儿童中,FICB 可有效减轻术后即刻躁动和术后疼痛的严重程度。

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