He Zhiwei, Ni Huanhuan, Wang Wei
Department of Anaesthesiology, Children's Hospital of Fudan University, Shanghai, China.
Department of Anaesthesiology, Children's Hospital of Nanjing Medical University, Nanjing, China.
Front Pediatr. 2024 Jun 19;12:1361330. doi: 10.3389/fped.2024.1361330. eCollection 2024.
This study aimed to investigate the effect of different doses of dexmedetomidine combined with sufentanil on postoperative analgesia in developmental hip dislocation in children after Salter osteotomy.
The clinical data of 98 children with developmental hip dislocation, who underwent Salter osteotomy in our center between January 2020 and February 2023, were selected. The children were randomly divided into four groups based on the application of patient-controlled intravenous analgesia (sufentanil + granisetron ± dexmedetomidine). All children received 1 µg/kg/day of sufentanil and 3 mg of granisetron. Group A did not receive dexmedetomidine, and Groups B, C, and D received 0.5, 0.75, and 1.0 µg/kg/day of dexmedetomidine, respectively. The pain indicators and immune factor levels of children in each group were compared.
The heart rate (HR) and respiratory rate (RR) 2 h after operation in Groups C and D were significantly lower than those in Groups A and B (< 0.05). The pain scores decreased over time after treatment in all groups. When compared at the same time point, children in Group D had the lowest pain scores, which were significantly lower than the other three groups (< 0.05). The total consumption of sufentanil in Groups C and D was significantly lower than that in Group A (< 0.05). On the first day after surgery, the children in Group D had lower levels of serum adrenocorticotropic hormone, interleukin-6, and corticosterone than those in Group A (< 0.05).
Administration of 1.0 µg/kg/day of dexmedetomidine combined with sufentanil in intravenous controlled analgesia after Salter osteotomy for developmental hip dislocation in children has a better analgesic effect, less consumption of sufentanil, and low incidence of opioid adverse reactions.
本研究旨在探讨不同剂量右美托咪定联合舒芬太尼对儿童发育性髋关节脱位行Salter截骨术后镇痛的影响。
选取2020年1月至2023年2月在我院中心接受Salter截骨术的98例发育性髋关节脱位患儿的临床资料。根据患者自控静脉镇痛（舒芬太尼+格拉司琼±右美托咪定）的应用情况将患儿随机分为四组。所有患儿均接受1μg/kg/天的舒芬太尼和3mg的格拉司琼。A组未接受右美托咪定，B、C、D组分别接受0.5、0.75和1.0μg/kg/天的右美托咪定。比较各组患儿的疼痛指标和免疫因子水平。
C组和D组术后2小时的心率（HR）和呼吸频率（RR）显著低于A组和B组（<0.05）。所有组治疗后疼痛评分均随时间下降。在同一时间点比较时，D组患儿的疼痛评分最低，显著低于其他三组（<0.05）。C组和D组舒芬太尼的总消耗量显著低于A组（<0.05）。术后第一天，D组患儿血清促肾上腺皮质激素、白细胞介素-6和皮质酮水平低于A组（<0.05）。
儿童发育性髋关节脱位行Salter截骨术后静脉自控镇痛中，给予1.0μg/kg/天的右美托咪定联合舒芬太尼具有较好的镇痛效果，舒芬太尼消耗量少，阿片类药物不良反应发生率低。
