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目的:比较小儿骶管注入不同浓度丁哌卡因(B)及芬太尼(F)的镇痛效果和安全性。方法:150例在骶麻下行斜疝修补术小儿随机分为五组:A组骶管注入1%利多卡因(L),B组注1%L+0.15%B,C组注1%L+0.25%B,D组注B组药及2μg·kg~(-1)F,E组注C组药及2μg·kg~(-1)F。术后4、8、12、24小时随访并记录肌力、疼痛评分(LPS)及副作用。结果:LPS<3级:B、C、D、E组各点明显多于A组;平均镇痛时间D组长于B组,E组长于C组;清醒后再嗜睡时间D、E组明显长于其它组,且减少了氯胺酮精神副作用;恶心呕吐D、E组多于A、B、C组;肌力恢复时间C、E组长于A、B、D组。结论:0.15%B(有或无芬太尼)是小儿斜疝修补术后的较好镇痛方法之一。
Objective: To compare the analgesic effect and safety of injecting bupivacaine (B) and fentanyl (F) in caudal peduncle of children. Methods: One hundred and fifty children undergoing oblique hernia repair in sacral hemorrhage were randomly divided into five groups: group A received caudal injection of 1% lidocaine (L), group B injected 1% L + 0.15% B and group C injected 1% L + 0.25% B, Group D injection of Group B drugs and 2μg · kg -1 F, E group injection Group C drugs and 2μg · kg -1 F. At 4, 8, 12, and 24 hours postoperatively, muscle strength, pain score (LPS) and side effects were recorded. Results: The levels of LPS <3 were significantly higher in group B, C, D and E than those in group A. The mean time to analgesia was longer in group D than in group B and longer in group E than in group C. In group D and E, Other groups, and reduce the side effects of ketamine; nausea and vomiting group D, E more than A, B, C group; muscle strength recovery time C, E group A, B, D group. Conclusion: 0.15% B (with or without fentanyl) is one of the better analgesic methods after pediatric hernia repair.