一般阻滞与尾侧阻滞在小儿脐下手术中的安全性和镇痛效果

Mohammed Mamun Morshed
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引用次数: 0

摘要

背景:尾侧镇痛在术中和术后疼痛管理中越来越流行,进一步使用佐剂延长其持续时间,每种效果不同。尾侧阻滞是儿科术后最首选的镇痛方法,尽管其作用时间有限。许多添加剂被用来提高尾侧阻滞的有效性,如阿片类药物或a2激动剂。最近,尾侧地塞米松作为术后镇痛药的使用有所增加。目的:本研究的目的是评估一般阻滞与尾侧阻滞在小儿脐下手术中的安全性和镇痛效果。方法:观察性研究。本研究对孟加拉国达卡乌塔拉阿德尼克医学院医院麻醉科的50名患者进行了调查,其中包括儿童。2022年1月至2022年12月期间。过去,对结果的统计评估是通过使用一个基于窗口的计算机软件程序来实现的,该程序是由社会科学统计软件包(SPSS-24)设计的。结果:布比卡因加无防腐剂可乐定组术后镇痛时间平均延长3倍。布比卡因溶液组比不含防腐剂的布比卡因可乐定组获得更多的抢救镇痛剂量(p值为0.004)。两组均无明显的心动过缓、低血压、镇静或尿潴留。6小时时无残余运动阻滞。两组的呕吐发生率相似。结论:地塞米松联合布比卡因可减少术后疼痛强度和总镇痛用量,延长镇痛时间。
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Safety and Analgesic Efficacy of General Versus Caudal Block in Pediatric Infra Umbilical Surgery
Background: Caudal analgesia has become popular in the management of intraoperative and postoperative pain management, further with the use of adjuvants to prolong its duration each with varying results. Caudal block is the most preferred postoperative analgesia in pediatrics, despite its limited duration of action. Many additives are used to improve the effectiveness of caudal blocks, such as opioids or a2 agonists. Recently, the use of caudal dexamethasone as an analgesic after surgery has increased. Objectives: The aim of this study is to evaluate the safety and analgesic efficacy of general versus caudal block in pediatric infra umbilical surgery. Methods: This is an observational study. This study was carried out on 50 patients the find out about the population including children in the Department of Anaesthesia, Uttara Adhunik Medical College Hospital, Dhaka, Bangladesh. The duration of the period from January 2022 to December 2022. Statistical evaluation of the results used to be got via the use of a window-based computer software program devised with Statistical Packages for Social Sciences (SPSS-24). Results: The mean duration of postoperative analgesia was 3 times longer in Bupivacaine with preservative free Clonidine Group. Bupivacaine solution Group received significantly more doses of rescue analgesic than Bupivacaine with preservative free Clonidine Group (p-value of 0.004). There was no significant bradycardia, hypotension, sedation or urinary retention in either of the groups. There was no residual motor blockade at 6 hours. Incidence of vomiting was similar in both the groups. Conclusion: Dexamethasone in combination with bupivacaine reduces postoperative pain intensity and total analgesic consumption and prolongs analgesia.
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