在儿科割礼中评估尾巴块增强:额外的止痛药是否有所不同?
1Department of Anesthesiology and Reanimation, Ordu University, Faculty of Medicine, Altınordu/Ordu, Turkey.
概括
对于儿科的割礼,尾巴块单独提供足够的缓解疼痛. 在尾部阻塞 (布皮瓦卡因) 中添加帕拉西托摩尔或梅佩里丁并没有改善疼痛缓解的质量或减少儿童的救援止痛需求.
科学领域:
- 儿科麻醉学 儿科麻醉学
- 疼痛管理 疼痛管理
- 泌尿外科手术 泌尿外科手术
背景情况:
- 尾部阻塞是儿童泌尿外科手术中多模式止痛的首选方法,例如割礼.
- 这项研究评估了尾巴阻断的有效性和在割礼手术中需要补充止痛的需要.
研究的目的:
- 为了研究单独使用尾巴阻塞与将尾巴阻塞与甲醇或美里丁结合用于儿科割礼中止痛的疗效.
- 为了确定在使用尾巴阻塞时是否需要救援止痛.
主要方法:
- 一项前性,单盲研究,涉及120名接受割礼的儿童 (1-12岁),随机分配到三个组:单独使用尾巴堵塞,用黄醇使用尾巴堵塞或用美丁使用尾巴堵塞.
- 用超声波引导的尾巴堵塞和0.125%的布皮瓦卡因被施用. 疼痛评分 (FLACC,Wong-Baker) 和止痛药消耗在24小时内进行了评估.
主要成果:
- 大多数时间组之间的FLACC或Wong-Baker疼痛得分没有显著差异.
- 在所有三组中,第一次救援止痛的时间和24小时总止痛药的消耗时间都相似.
- 在24小时的Wong-Baker疼痛评分 (P<0.001) 中观察到显著差异,尽管没有进一步的背景,临床意义尚不清楚.
结论:
- 将静脉注射的帕拉西他或梅佩里丁添加到尾巴块中并没有改善儿科割礼的止痛质量.
- 在这些手术中,仅靠尾部阻塞似乎就足以控制疼痛,而辅助药物没有明显的益处.
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