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布比卡因加或不加可乐定用于小儿患者骶管阻滞的镇痛效果

Analgesic Effect of Caudal Bupivacaine with or without Clonidine in Pediatric Patient.

作者信息

Khakurel Sharad, Sapkota Shanta, Karki Anuj Jung

机构信息

Department of Anesthesia and Intensive Care, National Trauma Centre, National Academy of Medical Sciences, Kathmandu, Nepal.

Department of Anesthesia and Intensive Care, National Academy of Medical Sciences, Bir Hospital, Kathmandu,Nepal.

出版信息

J Nepal Health Res Counc. 2019 Jan 28;16(41):428-433.

Abstract

BACKGROUND

Caudal analgesia has long been the cornerstone to successful pain management in children undergoing abdominal and lower limb surgeries. Its analgesic duration with single shot injection is however limited. So adjuvants are used with local anesthetics in an attempt to increase the duration of caudal analgesia. This study aims to investigate the duration of analgesia provided by Clonidine when added to caudal Bupivacaine.

METHODS

A randomized, double blinded, comparative study was conducted on 64 patients, aged two to seven years, scheduled for unilateral inguinal hernia repair. Patients were randomly allocated into two groups of 32 each, with group A receiving bupivacaine two milligram/kilogram and group B receiving bupivacaine two milligram/kilogram with one microgram/kilogramclonidine, (total volume of injectate was one milliliter/kilogram). Duration of analgesia, hemodynamic response and adverse effects, if any were noted.

RESULTS

Mean duration of analgesia in group A was 264.12 ± 68.77 minutes and in group B was 520 ± 57.37 minutes, p-value <0.001.Incidence of vomiting was 9% in group A compared to 6% in group B.

CONCLUSIONS

Clonidineas an adjuvant to caudal bupivacaine prolongs the duration of analgesia without increasing the adverse effects.

摘要

背景

长期以来,骶管阻滞一直是接受腹部和下肢手术儿童成功进行疼痛管理的基石。然而,单次注射的镇痛持续时间有限。因此,佐剂与局部麻醉剂联合使用,试图延长骶管阻滞的镇痛持续时间。本研究旨在探讨可乐定加入骶管布比卡因后的镇痛持续时间。

方法

对64例年龄在2至7岁、计划进行单侧腹股沟疝修补术的患者进行了一项随机、双盲、对照研究。患者被随机分为两组,每组32例,A组接受2毫克/千克布比卡因,B组接受2毫克/千克布比卡因加1微克/千克可乐定(注射剂总体积为1毫升/千克)。记录镇痛持续时间、血流动力学反应和不良反应(如有)。

结果

A组的平均镇痛持续时间为264.12±68.77分钟,B组为520±57.37分钟,p值<0.001。A组呕吐发生率为9%,B组为6%。

结论

可乐定作为骶管布比卡因的佐剂可延长镇痛持续时间,且不增加不良反应。

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