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腹腔镜腹股沟疝修补术患儿术后镇痛的全身利多卡因输注:一项随机双盲对照试验

Systemic Lidocaine Infusion for Post-Operative Analgesia in Children Undergoing Laparoscopic Inguinal Hernia Repair: A Randomized Double-Blind Controlled Trial.

作者信息

Lee Hye-Mi, Choi Kwan-Woong, Byon Hyo-Jin, Lee Ji-Min, Lee Jeong-Rim

机构信息

Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.

Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.

出版信息

J Clin Med. 2019 Nov 18;8(11):2014. doi: 10.3390/jcm8112014.

Abstract

Systemic lidocaine can provide satisfactory post-operative analgesia in adults. In this study, we assessed whether intravenous lidocaine is effective for post-operative analgesia and recovery in children undergoing laparoscopic inguinal hernia repair. A total of 66 children aged from six months to less than six years were classified in either the lidocaine (L) or control (C) groups. Children in Group L received a lidocaine infusion (a bolus dose of 1 mL kg, followed by a 1.5 mg kg h infusion), whereas Group C received the same volume of 0.9% saline. The primary outcome was the number of patients who presented face, legs, activity, crying and consolability (FLACC) scores of four or more, and therefore received rescue analgesia in the post-anesthesia recovery care unit (PACU). Secondary outcomes included the highest FLACC score in the PACU, FLACC, and the parents' postoperative pain measure (PPPM) score at 48 h post-operation, as well as side effects. The number of children who received rescue analgesia in the PACU was 15 (50%) in Group L and 22 (73%) in Group C ( = 0.063). However, the highest FLACC score in PACU was lower in Group L (3.8 ± 2.4) than in Group C (5.3 ± 2.7) ( = 0.029). In conclusion, systemic lidocaine did not reduce the number of children who received rescue analgesia in PACU.

摘要

全身性利多卡因可为成人提供满意的术后镇痛效果。在本研究中,我们评估了静脉注射利多卡因对接受腹腔镜腹股沟疝修补术的儿童术后镇痛及恢复是否有效。共有66名年龄在6个月至6岁以下的儿童被分为利多卡因组(L组)或对照组(C组)。L组儿童接受利多卡因输注(首剂剂量为1 mL/kg,随后以1.5 mg·kg⁻¹·h⁻¹输注),而C组儿童接受相同体积的0.9%生理盐水。主要结局指标为在麻醉后恢复护理单元(PACU)中面部、腿部、活动、哭闹及安抚情况(FLACC)评分达到4分或更高从而接受补救性镇痛的患者数量。次要结局指标包括PACU中最高FLACC评分、术后48小时的FLACC评分以及父母术后疼痛测量(PPPM)评分,还有副作用。在PACU中接受补救性镇痛的儿童数量,L组为15名(50%),C组为22名(73%)(P = 0.063)。然而,L组在PACU中的最高FLACC评分(3.8±2.4)低于C组(5.3±2.7)(P = 0.029)。总之,全身性利多卡因并未减少在PACU中接受补救性镇痛的儿童数量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d04/6912688/4a77fe468708/jcm-08-02014-g001.jpg

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