超声引导下左布比卡因联合右美托咪啶行肋间神经阻滞对小儿NUSS手术术后镇痛的效果

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Abstract Objective To investigate the effect of ultrasound guided Levobupivacaine combined with Dexmedetomidine on postoperative sedation and postoperative pain score in children undergoing NUSS surgery. Methods From November 1, 2014 to March 1, 2017, 60 children aged 3 to 6 years who received NUSS operation in the Department of Anesthesiology of Guangzhou Women and Children′s Medical Center were selected as the research objects. They were divided into group BD, group B and group C three groups according to the random number table, 20 cases in each group. 0.25% Levobupivacaine and 1 μg/mL Dexmetidine under ultrasound guidance were used to block intercostal nerve after tracheal intubation and general anesthesia in children of group BD, and postoperative analgesia was performed with opioid drugs by self-controlled intravenous administration of PCIA. 0.25% Levobupivacaine under ultrasound guidance were used to block intercostal nerve after tracheal intubation and general anesthesia in children of group B and PCIA was used for the analgesia after operation. The children in group C were operated directly after general anesthesia with tracheal intubation, and PCIA was given for the analgesia after operation. The Riker sedation agitation score of postoperative recovery and extubation, postoperative FLACC pain score, the effective pressing times and actual pressing times of PCIA the cumulative dosage of Sufentanil within 24 h after operation were observed and recorded. The percentage of analgesic failure was calculated. Results The scores of Riker sedation and restlessness in group BD, B and C were (4.0±0.0), (4.0±0.0) and (5.0±0.0) scores respectively. FLACC pain scores at 2, 4, 6, 8, 12, 24 h and 48 h after operation showed that group BD < group B < group C, and the differences between groups were statistically significant (P < 0.01). There were statistically significant differences among the three groups in the number of effective PCIA compressions and actual compressions (P < 0.05). The effective times and actual times of compressions in group C were significantly higher than those in group B and BD, and the differences were statistically significant (P < 0.05). The cumulative dosage of Sufentanil in 24 h was group BD < group B < group C, and the difference was statistically significant (P < 0.05). The percentage of postoperative analgesia failure in the three groups was statistically significant (P < 0.05). Conclusion Ultrasound guided intercostal nerve block combined with PCIA is more effective than PCIA alone in relieving postoperative pain in children with NUSS. Dexmetidine can enhance the effect of Levobupivacaine on intercostal nerve block, and lower the dosage of Sufentanil. It is more suitable for postoperative analgesia after NUSS.

Key words： Dexmedetomidine Levobupivacaine Intercostal nerve block under ultrasound guidance Children NUSS surgery Postoperative analgesia

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	QIU Qianqi TIAN Hang SONG Xingrong XU Yingyi

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QIU Qianqi TIAN Hang SONG Xingrong XU Yingyi. Analgesic effect of Levobupivacaine combined with Dexmetidine in intercostal nerve block after NUSS operation in children[J]. 中国医药导报, 2018, 15(19): 104-108.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2018/V15/I19/104

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