Jebeles J A, Reilly J S, Gutierrez J F, Bradley E L, Kissin I
Division of Otolaryngology-Head and Neck Surgery, University of Alabama School of Medicine, Birmingham.
Int J Pediatr Otorhinolaryngol. 1993 Jan;25(1-3):149-54. doi: 10.1016/0165-5876(93)90048-8.
Experimental data in humans and animals suggest that during surgery, pain impulses enter the CNS creating a hyperexcitable state in spite of general anesthesia. In a prospective double blind study, pain levels in 22 children undergoing tonsillectomy and adenoidectomy under general anesthesia were compared from day of surgery to Day 10. Patients received pre-incisional infiltration with either bupivacaine (A) or saline (B). Subjective pain was assessed by visual analog scale, and objective pain by deglutition time (100 ml). Subjective constant pain was less (P < 0.05) in group (A) on Day 1: 16 (A) vs. 59 (B) and Day 5: 4 (A) vs. 45 (B). We conclude that local nerve blockade by bupivacaine reduces short- and long-term pain in children undergoing tonsillectomy and adenoidectomy in the presence of general anesthesia.
人和动物的实验数据表明，在手术过程中，尽管使用了全身麻醉，但疼痛冲动仍会进入中枢神经系统，从而产生一种过度兴奋的状态。在一项前瞻性双盲研究中，对22例在全身麻醉下接受扁桃体切除术和腺样体切除术的儿童，从手术当天到第10天的疼痛程度进行了比较。患者在切口前分别接受布比卡因（A组）或生理盐水（B组）浸润。主观疼痛通过视觉模拟量表进行评估，客观疼痛通过吞咽时间（100毫升）进行评估。在第1天，A组的主观持续疼痛较轻（P<0.05）：A组为16分，B组为59分；在第5天，A组为4分，B组为45分。我们得出结论，在全身麻醉的情况下，布比卡因进行局部神经阻滞可减轻接受扁桃体切除术和腺样体切除术儿童的短期和长期疼痛。
