The application of Dexmedetomidine combined with Sulfentanyl for postoperative analgesia in children's inguinal area
ZHANG Jie1 LI Jianling2 CUI Yan3
1.Department of Anesthesiology, Chengde Hospital of Traditional Chinese Medicine, Hebei Province, Chengde 067000, China;
2.Department of Anesthesiology, Affiliated Hospital of Chengde Medical University, Hebei Province, Chengde 067000, China;
3.Department of Anesthesiology, Chinese People's Liberation Army No. 266 Hospital, Hebei Province, Chengde 067000, China
Abstract:Objective To explore the value of Dexmedetomidine combined with Sulfentanyl for postoperative analgesia in children's inguinal area. Methods From June 2016 to June 2017, 100 cases of inguinal area operation and general anesthesia for children were studied in Chengde Hospital of Traditional Chinese Medicine and Affiliated Hospital of Chengde Medical University. According to the random number table method, they were randomly divided into observation group (n = 50, using Dexmedetomidine combined with Sulfentanyl for postoperative analgesia) and control group (n = 50, conventional analgesics for postoperative analgesia). HR, MAP, Ramsay score, Wong-Baker facial expression scale and adverse reactions were compared at different times after operation (i.e. T1: immediately after operation; T2: postoperative 2 h; T3: postoperative 4 h; T4: postoperative 8 h) between two groups. Results At T2, HR and MAP of children in the two groups were lower than T1, the differences were statistically significant (P < 0.05), while in T1, T2, T3 and T4 time, there was no significant difference in HR and MAP between the two groups and the differences were not statistically significant (P > 0.05). The Ramsay scores at T2, T3 and T4 in two groups were all higher than those at T1, the scores at T2, T3 and T4 in the observation group were higher than those in the control group(P < 0.05). At T2, Wong-Baker facial expression scale scores of two groups were higher than those at T1, Wong-Baker facial expression scale scores of the observation group at T2, T3, T4 were lower than those of the control group, and the differences were all statistically significant (P < 0.05). The incidence of adverse reactions in the observation group was 14.00%, and the incidence of adverse reactions in the control group was 10.00%. There was no statistical significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion Dexmedetomidine combined with Sulfentanyl has good analgesic effect in children after inguinal surgery. It has little influence on hemodynamics and safety, and it is worthy of clinical application.
张洁1 李建玲2 崔艳3. 右美托咪定复合舒芬太尼在小儿腹股沟区手术术后镇痛中的应用[J]. 中国医药导报, 2018, 15(16): 80-84.
ZHANG Jie1 LI Jianling2 CUI Yan3. The application of Dexmedetomidine combined with Sulfentanyl for postoperative analgesia in children's inguinal area. 中国医药导报, 2018, 15(16): 80-84.
1] 苏震,李建玲,李汝泓,等.右美托咪定用于全麻联合区域阻滞下小儿腹股沟区手术的效果[J].现代中西医结合杂志,2016,25(29):3286-3288.
[2] 阿不都海力,阿地里江,塔依尔,等.曲马多与舒芬太尼治疗瑞芬太尼复合麻醉术后急性疼痛的效果分析[J].转化医学电子杂志,2015,2(9):126-127.
[3] 荆双凤,郑丽宏,郑丽坤.盐酸右美托咪定在术后镇痛中的应用[J].现代肿瘤医学,2017,25(12):2008-2010.
[4] 库马尔,庞启颖,张晓庆.阿片类镇痛药与局麻药联合应用于椎管内麻醉的效果评价[J].外科研究与新技术,2017,6(1):48-52.
[5] Lu CH,Chen JL,Wu CT,et al. Effect of Epidural Neuraxial Blockade-dependent Sedation on the Ramsay Sedation Scale and the Composite Auditory Evoked Potentials Index in Surgical Intensive Care Patients [J]. J Formo Med Assoc,2010,109(8):589-595.
[6] 龚宗容,舒敏,万朝敏,等.Wong-Baker面部表情疼痛量表对0至5岁急性发热儿童舒适度评估的效果[J].中国循证儿科杂志,2015,10(6):401-404.
[7] 李琛,黄丽华.术后疼痛管理研究进展[J].护理与康复,2015,14(4):330-333.
[8] Deberry JJ,Robbins MT,Ness TJ. The amygdala central nucleus is required for acute stress-induced bladder hyperalgesia in a rat visceral pain model [J]. Brain Research,2015,1606:77-85.
[9] Telen MJ,Afenyi-Annan A,Garrett ME,et al. Alloimmu- nization in sickle cell disease:changing antibody specificities and association with chronic pain and decreased survival [J]. Transfusion,2015,55(2):1378-1387.
[10] Jwr S,Schimmel M,Luken BM,et al. Dynamics of von Willebrand factor reactivity in sickle cell disease during vaso-occlusive crisis and steady state [J]. J Thrombo Haemost,2017,15(7):1392-1402.
[11] 黄宏伟,张营,蔡雨,等.腰丛-坐骨神经阻滞麻醉与腰硬联合麻醉用于下肢手术的血流动力学及临床效果观察[J].山西医药杂志,2016,45(5):563-565.
[12] 滕清宇,李玮伟,袁红斌,等.全麻药发育期神经毒性机制的研究进展[J].临床麻醉学杂志,2016,32(9):929-931.
[13] 陈婷,林献忠.麻醉药对小儿术后认知功能影响的研究进展[J].医学综述,2016,22(18):3652-3655.
[14] Elfawal SM,Abdelaal WA,Hosny MR. A comparative study of dexmedetomidine and fentanyl as adjuvants to levobupivacaine for caudal analgesia in children undergoing lower limb orthopedic surgery [J]. Saudi J Anaesth,2016,10(4):423-427.
[15] Elfeky EM,Aziz AAAE. Fentanyl,dexmedetomidine,dexamethasone as adjuvant to local anesthetics in caudal analgesia in pediatrics:A comparative study [J]. Egypt J Anaesth,2015,31(2):175-180.
[16] Khan AL,Singh RB,Tripathi RK,et al. A comparative study between intrathecal dexmedetomidine and fentanyl as adjuvant to intrathecal bupivacaine in lower abdominal surgeries:A randomized trial [J]. Anesth Essays Res,2015,9(2):139-148.
[17] Sarma J,Narayana PS,Ganapathi P,et al. A comparative study of intrathecal clonidine and dexmedetomidine on characteristics of bupivacaine spinal block for lower limb surgeries [J]. Anesth Essays Res,2015,9(2):195-207.
[18] Sang JP,Shin S,Kim SH,et al. Comparison of Dexme- detomidine and Fentanyl as an Adjuvant to Ropivacaine for Postoperative Epidural Analgesia in Pediatric Orthopedic Surgery [J]. Yonsei Med J,2017,58(3):650-657.
[19] Aet S,Oya K. Influence of Addition of Dexmedetomidine or Fentanyl to Bupivacaine Lumber Spinal Subarachnoid Anesthesia for Inguinal Hernioplasty [J]. Anesth Essays Res,2017,11(3):554-557.
[20] 秦寿泽,先锋,郭斌.右美托咪啶对小儿全麻腹股沟疝修补术后的疗效观察[J].中国医药导刊,2015,17(11):1146-1147.