临床小儿外科杂志2024，Vol.23Issue(12)：1174-1179,6.DOI:10.3760/cma.j.cn101785-202310042-012
耳穴疗法在小儿骨科截骨手术后多模式镇痛中的应用研究
Application of auricular acupoint therapy after multimodal postoperative analgesia for lower extremity osteotomy in children
摘要
Abstract
Objective To evaluate the efficacy of auricular acupressure plus sufentanil after multimodal postoperative analgesia for lower extremity osteotomy in children and provide clinical evidence for its application in postoperative pain management.Methods For this prospective randomized controlled study,100 children aged 6-12 years with ASA physical status grade Ⅰ-Ⅱ undergoing elective lower extremity osteotomy were selected.They were randomized into two groups of auricular point(E group)and control(C group)(n=50 each).Both groups received conventional sufentanil intravenous patient-controlled analgesia(Ⅳ-PCA)after surgery.In E group,auricular bean pressing before the end of operation and pressed auricle after operation were performed.In C group,auricular taping of both ears before the end of operation and there was no pressing of bean or auricle.Children's Hospital of Eastern Ontario Pain Scale(CHEOPS)scores at2h(T0),6 h(T1),12 h(T2),24 h(T3)and 48 h(T4)post-operation were recorded in both groups.Number of PCA presses and use of ibuprofen for remedial analgesia were recorded at 48h post-operation.Venous blood was collected at the time of skin suture and 48h post-operation for detecting the serum concentrations of C-reactive protein(CRP)and beta-endorphin(β-EP).The postoperative occurrences of respiratory depression,nausea & vomiting and skin pruritus were observed.Results A total of 97 children(E group 48,C group49)successfully completed this study.No significant inter-group difference existed in general profiles.The resting and movement CHEOPS pain scores for two groups at T0 were(3.48±0.77),(3.63±0.79)and(3.69±0.77),(3.82±0.78)points;At T1,(3.58±0.77),(4.27±0.82)and(3.73±0.64),(4.16±0.77)points;AtT2,(4.25±0.79),(4.44±0.77)and(6.35±1.03),(6.43±1.04)points.At T3,(4.38±0.84),(4.58±0.90)and(5.84±0.77),(4.58±0.90)points;At T4,(5.19±0.70),(5.58±0.65)and(5.63±1.03),(5.84±0.96)points.Statistically significant inter-group differences existed in resting and movement pain scores at T2 and T3 while there were no statistically significant differences at other timepoints.The effective number of PCA presses was 18(12,29)times in E group while 30(15,38)times in C group.Ibuprofen analgesic rescue rate was19％(9/48)in E group versus 57％(28/49)in C group.CRP level 48h was(44.04±1.87)mg/L in E group versus(67.04±5.91)mg/L in C group.β-EP level was(48.70±13.52)pg/mL in E group versus(34.95±2.86)pg/mL in C group.The incidence of postoperative nausea and vomiting was 4％(2/48)in E group versus 20％(10/49)in C group.Postoperative analgesia family satisfaction score was 8(8,9)points in E group versus 5(5,6)points in C group.All of the above results showed statistically significant differences(P＜0.05).There was no postoperative onset of respiratory depression or skin pruritus.Conclusions Auricular point therapy effectively may reduce postoperative pain,decrease analgesic usage and lower nausea and vomiting incidence lower extremity osteotomy in children.It offers a safe and viable option for perioperative pediatric care.关键词
耳穴疗法/镇痛/疼痛管理/截骨术/下肢/儿童Key words
Auriculotherapy/Analgesia/Pain Management/Osteotomy/Lower Extremity/Child引用本文复制引用
梁明超,肖婷,李海霞,杜真,汤可香,屈双权..耳穴疗法在小儿骨科截骨手术后多模式镇痛中的应用研究[J].临床小儿外科杂志,2024,23(12):1174-1179,6.基金项目
湖南省科技厅临床技术创新引导计划项目(2021SK50508) Clinical Technology Innovation Guidance Project of Hunan Provincial Department of Sci-ence & Technology(2021SK50508) （2021SK50508）
