Eladi Islam Adel, Mourad Karim Hussein, Youssef Ahmed Nabih, Abdelrazek Abdelrazek Ahmed, Ramadan Mohammad Ahmed
Department of Anesthesia, Surgical Intensive Care Unit and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt.
Open Access Maced J Med Sci. 2019 Mar 29;7(7):1082-1086. doi: 10.3889/oamjms.2019.243. eCollection 2019 Apr 15.
Pain is a major postoperative complication worldwide, which in turn impairs normal body performance and increases postoperative morbidity, hospitalisation, and the susceptibility to infections which also lead to chronic pain development.
The purpose of this study was to evaluate the efficacy of intravenous ketorolac versus nalbuphine as analgesia after adenotonsillectomy surgery to determine the optimal procedure for pain control and postoperative reduction of analgesic use.
A group of 100 pediatric patients undergoing tonsillectomy or adenotonsillectomy were assigned as follows to two equal groups: Group A: 50 patients received intravenous ketorolac 0.9 mg/Kg. Group B: 50 patients received intravenous nalbuphine 0.25 mg/Kg.
FLACC (Face, Legs, Activity, Cry, Consolability) pain score was measured after recovery from anaesthesia (postoperative). There was a statistically significant difference concerning pain score between group 'A' and group 'B' as pain score in 'A' (ranging from 3.18 ± 0.87 to 4.68 ± 0.74) is lower compared to 'B' (ranging from 3.90 ± 0.76 to 5.54 ± 0.73) and probability value < 0.05 except at 90 & 120 min which was observed statistically insignificant. There was no serious postoperative complication detected in either group.
It is concluded that intravenous ketorolac is more effective than intravenous nalbuphine in reducing pain intensity and postoperative analgesic requirements after adenotonsillectomy in children.
疼痛是全球范围内主要的术后并发症，进而损害身体正常机能，增加术后发病率、住院时间以及感染易感性，而感染又会导致慢性疼痛的发生。
本研究旨在评估静脉注射酮咯酸与纳布啡在腺样体扁桃体切除术后镇痛的疗效，以确定控制疼痛及减少术后镇痛药物使用的最佳方法。
将100例行扁桃体切除术或腺样体扁桃体切除术的儿科患者平均分为两组：A组：50例患者静脉注射酮咯酸0.9mg/kg。B组：50例患者静脉注射纳布啡0.25mg/kg。
在麻醉恢复后（术后）测量面部、腿部、活动、哭闹、安慰（FLACC）疼痛评分。A组和B组之间的疼痛评分存在统计学显著差异，因为A组的疼痛评分（范围为3.18±0.87至4.68±0.74）低于B组（范围为3.90±0.76至5.54±0.73），概率值<0.05，但在90分钟和120分钟时差异无统计学意义。两组均未检测到严重的术后并发症。
得出结论，在减轻儿童腺样体扁桃体切除术后的疼痛强度和术后镇痛需求方面，静脉注射酮咯酸比静脉注射纳布啡更有效。
