中国医学创新2023，Vol.20Issue(34)：1-7,7.DOI:10.3969/j.issn.1674-4985.2023.34.001
达克罗宁联合右美托咪定及酮咯酸氨丁三醇对小儿隐匿性阴茎术后镇痛和应激的影响
Effects of Dyclonine Combined with Dexmedetomidine and Ketorolac Tromethamine on Analgesia and Stress after Concealed Penis Surgery in Children
摘要
Abstract
Objective:To analyze the effects of Dyclonine combined with Dexmedetomidine and Ketorolac Tromethamine on analgesia and stress after concealed penile surgery in children.Method:A total of 120 children who underwent elective tracheal intubation and concealed penis surgery under general anesthesia in Jiujiang NO.1 People's Hospital from June to September 2022 were selected as research subjects.The children were divided into group A(Ketorolac Tromethamine + Dyclonine Mucilage for analgesia),group B(Dexmedetomidine + Dyclonine Mucilage for analgesia)and group C(Dexmedetomidine + Ketorolac Tromethamine+ Dyclonine Mucilage for analgesia)by the random number table method,with 40 cases in each group.All children were given intravenous inhalation anesthesia.Intraoperative hemodynamics[heart rate(HR)and mean arterial pressure(MAP)at the beginning of surgery(T0),at 30 min after the beginning of surgery(T1)and at the time of recovery(T2)]and intraoperative doses of Propofol,Fentanyl and Remifentanil were recorded among the three groups.The differences in pain[Children's Hospital of Eastern Ontario pain scale(CHEOPS)score],sedation[anesthesia recovery agitation scoring system(Watcha)score]and laboratory indicators[cortisol(Cor),epinephrine(E),blood glucose(Glu)]were compared among the three groups at 1,24,48 h after surgery,and the drug safety in the three groups was evaluated.Result:The HR and MAP in the three groups were decreased first and then increased(P<0.05),and the HR and MAP in group C were lower than those in group A and group B group at T1 and T2(P<0.05),but there were no significant interaction effects of between-group and time-point(P>0.05).The intraoperative dose of Propofol in group C was significantly less than those in group A and group B(P<0.05).There were no statistical differences in intraoperative doses of Fentanyl and Remifentanil among the three groups(P>0.05).CHEOPS,Watcha scores and levels of Cor and E in the three groups had significant interaction effects(P<0.05).CHEOPS score and Watcha scores in the three groups at 24 h after surgery were higher than those at 1 h after surgery,and the scores at 48 h after surgery were lower than those at 24 h after surgery(P<0.05).CHEOPS and Watcha scores at 1,24 h after surgery in group C were lower than those in group A and group B(P<0.05).The levels of Cor and E in the three groups at 24,48 h after surgery were lower than those at 1 h after surgery,and those at 48 h after surgery were lower than those at 24 h after surgery(P<0.05).The levels of Cor and E in group C at 1,24 h after surgery were lower than those in group A and group B(P<0.05).The Glu levels in the three groups showed a decreasing trend after surgery(P<0.05),and the Glu levels in group C were lower than those in group A and group B at 1,24 h after surgery(P<0.05),but there was no significant interaction effect of between-group and time-point(P>0.05).The adverse reactions included hypotension,vomiting and drowsiness in the three groups,and the total incidence rates were 12.50%,12.50% and 5.00% respectively,with no statistical significance between the groups(P>0.05).Conclusion:The postoperative analgesic effect of Dyclonine combined with Dexmedetomidine and Ketorolac Tromethamine for concealed penis surgery in children is better,which can reduce stress response,reduce the dosage of Propofol and reduce postoperative agitation in children.关键词
小儿隐匿性阴茎术/达克罗宁/右美托咪定/酮咯酸氨丁三醇Key words
Concealed penis surgery in children/Dyclonine/Dexmedetomidine/Ketorolac Tromethamine引用本文复制引用
赵小平,费海彬,苏奕,钟声宏,党秀静..达克罗宁联合右美托咪定及酮咯酸氨丁三醇对小儿隐匿性阴茎术后镇痛和应激的影响[J].中国医学创新,2023,20(34):1-7,7.基金项目
九江市重点研发计划-指导性计划项目(S2022ZDYFN296) （S2022ZDYFN296）
