张天宇 1杜晶晶 1李梦 2李梦雅 2李雪 2陈莺2
作者信息
- 1. 锦州医科大学连云港市第一人民医院研究生培养基地麻醉科,江苏连云港 222000
- 2. 徐州医科大学附属连云港医院麻醉科,江苏连云港 222000
- 折叠
摘要
Abstract
Objective To observe the clinical efficacy and safety of esketamine injection combined with sufentanil injection for patient-controlled intravenous analgesia(PCIA)after fracture surgery in children.Methods Children scheduled for elective limb fracture incision and internal fixation were randomly divided into control group and treatment group.The control group was given 2 μg·kg-1 sufentanil for PCIA;the treatment group was given 1.0 mg·kg-1 esketamine combined with 1.5 μg·kg-1 sufentanil for PCIA.Background dose of 2 groups:2 mL·h-1,single dose of 2 mL each time,locking time of 15 min,total volume of 100 mL.The facial expression,leg movement,mobility,crying,consolability scale(FLACC)scores and Ramsay sedation scores,analgesic drug consumption and PCIA compression times within 48 h after operation,and adverse drug reactions were compared between the two groups at different time points after operation.Results Forty subjects enrolled in the treatment group,1 dropped out,and 39 were finally included in the statistical analysis;40 subjects enrolled in the control group,2 dropped out,and 38 were finally included in the statistical analysis.After treatment,the FLACC scores of treatment group at 2,4,6,12,24 and 48 h after operation were(4.75±0.93),(2.50±0.97),(1.75±0.93),(2.06±1.18),(1.13±0.62)and(0.50±0.63)points,which in control group were(6.13±1.13),(3.80±1.21),(2.87±0.64),(3.47±1.13),(1.87±0.92)and(1.27±0.80)points,and there were significant differences in the two groups(all P＜0.05).The Ramsay sedation scores of treatment and control groups at 2 hours after operation were(2.25±0.45)and(1.47±0.52)points;the number of effective PCIA compressions within 24 hours was 4.25±3.94 and 8.13±5.71;the amount of analgesic drugs used within 24 hours after surgery was(52.38±9.11)and(61.47±12.82)mL;the amount of analgesic drugs used within 48 hours after surgery was(88.81±14.31)and(94.60±5.93)mL,respectively;and the differences were statistically significant(all P＜0.05).The adverse drug reactions of two groups were mainly dizziness,nausea and vomiting.The total incidences of adverse drug reactions in treatment and control groups were 53.85％and 84.21％with significant difference(P＜0.05).Conclusion Esketamine injection combined with sufentanil injection can reduce postoperative pain intensity,improve analgesic sedation effect and reduce the incidence of adverse reactions of analgesic pump after fracture surgery in children.关键词
艾司氯胺酮注射液/舒芬太尼注射液/小儿骨科/术后镇痛/自控静脉镇痛/安全性评价Key words
esketamine injection/sufentanil injection/pediatric orthopedic/postoperative analgesia/patient-controlled intravenous analgesia/safety evaluation分类
医药卫生
