岭南现代临床外科2025，Vol.25Issue(3)：190-195,6.DOI:10.3969/j.issn.1009-976X.2025.03.008
小剂量艾司氯胺酮在儿童隐匿阴茎矫正术后自控静脉镇痛的应用
Application of small dose of esketamine on patient-controlled intravenous analgesia in children after concealed penile correction surgery
摘要
Abstract
Objective To investigate the effect of low-dose esketamine combined with sufentanil on patient-controlled intravenous analgesia(PCIA)in children after allergic penile correction surgery.Methods In this study,a total of 90 children aged 4 to 12 years who were scheduled to undergo corrective surgery for concealed penis were selectedand divided equally into SE0,SE1 and SE2 groups.All children received anethesia induction with sufentanil and esketamine,while a sacral block was performed under ultrasound guidance and intraoperative anaesthesia was maintained with 1.3 MAC sevoflurane.The post-operative self-administered intravenous analgesia regimen was:1 μg/(kg·24 h)of sufentanil in group SE0,1 μg/(kg·24 h)of sufentanil+esketamine 0.5 mg/(kg·24 h)in group SE1 and 1 μg/kg of sufentanil+esketamine 1 mg/kg in group SE2,all diluted with 0.9% saline to 200 ml.Heart rate,mean arterial pressure,delirium score during anesthesia awakening,Wong-Baker analgesia score,Ramsay sedation score,number of postoperative analgesic pump presses,sufentanil dosage and occurrence of adverse effects were recorded in the three groups of children.Results The SE1 and SE2 groups experienced fewer postoperative analgesic pump presses and less sufentanil than the SE0 group(P<0.0165).The SE2 group achieved fewer analgesic pump presses and less sufentanil consumption than the SE1 group,and had higher Ramsay sedation scores at T4 than the SE1 and SE0 groups(P<0.05).At remaining moments,there were no significant differences between the groups in terms of delirium scores,analgesia,sedation scores,heart rate,mean arterial pressure and incidence of adverse reactions during the awakening period of paediatricanaesthesia(P>0.05).Conclusion Low-dose esketamine combined with sufentanil PCIA achieves satisfactory postoperative analgesia in children undergoing hidden penis correction surgery,reduces total sufentanil dosage,and avoids emergence delirium or other significant adverse reactions.关键词
艾司氯胺酮/儿童/隐匿阴茎矫正术/术后自控静脉镇痛Key words
esketamine/children/concealed penile correction surgery/postoperative patient-con-trolled intravenous analgesia分类
医药卫生引用本文复制引用
高宁阳,袁超,周林,张理宾..小剂量艾司氯胺酮在儿童隐匿阴茎矫正术后自控静脉镇痛的应用[J].岭南现代临床外科,2025,25(3):190-195,6.基金项目
广东省妇幼保健院课题(20210003) （20210003）
