PDF(Pubmed)
Abstract：
UNASSIGNED: Transanal endorectal pull-through (TERPT) is a standard procedure for managing paediatric patients with Hirschsprung\'s disease (HD). This study aimed to evaluate peri-anal infiltration versus caudal block as a part of multimodal analgesia for paediatric patients with HD undergoing the TERPT procedure.
UNASSIGNED: This randomised trial included 60 patients of both genders, aged 6 to 18 months who underwent the TERPT procedure under general anaesthesia. The patients were randomly assigned into two groups to receive either peri-anal infiltration or caudal block with 1 ml/kg bupivacaine 0.25% and dexmedetomidine 1 µg/kg in 0.5 ml normal saline. The primary outcome was the time to the first rescue analgesia. The secondary outcomes were the total consumption, the frequency of nalbuphine administration as rescue analgesia within 24 hours and the level of postoperative sedation.
UNASSIGNED: The time to first rescue analgesia was significantly shorter in the peri-anal infiltration group versus the caudal block group (median [interquartile range] 10 [7.5-12.5] h versus 16 [13.5-18.5] h, respectively, P = 0.008). The frequency of administration and the total dose of nalbuphine was significantly higher in the peri-anal infiltration group (P = 0.003 and 0.013, respectively). The sedation score was significantly higher in the caudal block group postoperatively.
UNASSIGNED: For paediatric patients undergoing the TERPT procedure, peri-anal infiltration was less effective than caudal block in terms of the duration of postoperative analgesia. However, both techniques were comparable during the first 6 hours postoperatively.
UNASSIGNED: This randomised trial included 60 patients of both genders, aged 6 to 18 months who underwent the TERPT procedure under general anaesthesia. The patients were randomly assigned into two groups to receive either peri-anal infiltration or caudal block with 1 ml/kg bupivacaine 0.25% and dexmedetomidine 1 µg/kg in 0.5 ml normal saline. The primary outcome was the time to the first rescue analgesia. The secondary outcomes were the total consumption, the frequency of nalbuphine administration as rescue analgesia within 24 hours and the level of postoperative sedation.
UNASSIGNED: The time to first rescue analgesia was significantly shorter in the peri-anal infiltration group versus the caudal block group (median [interquartile range] 10 [7.5-12.5] h versus 16 [13.5-18.5] h, respectively, P = 0.008). The frequency of administration and the total dose of nalbuphine was significantly higher in the peri-anal infiltration group (P = 0.003 and 0.013, respectively). The sedation score was significantly higher in the caudal block group postoperatively.
UNASSIGNED: For paediatric patients undergoing the TERPT procedure, peri-anal infiltration was less effective than caudal block in terms of the duration of postoperative analgesia. However, both techniques were comparable during the first 6 hours postoperatively.
摘要：
■经肛门直肠内穿刺（TERPT）是治疗先天性巨结肠病（HD）儿科患者的标准程序。这项研究旨在评估接受TERPT手术的小儿HD患者的肛周浸润与尾阻滞作为多模式镇痛的一部分。
■这项随机试验包括60名男女患者，年龄6至18个月，在全身麻醉下接受TERPT手术。患者被随机分为两组，分别接受肛门周围浸润或在0.5ml生理盐水中使用1ml/kg布比卡因0.25％和1µg/kg右美托咪定的尾部阻滞。主要结局是首次抢救镇痛的时间。次要结果是总消费量，24小时内纳布啡作为抢救镇痛的频率和术后镇静水平。
■肛门周围浸润组与尾部阻滞组相比，首次抢救镇痛时间明显缩短（中位数[四分位距]10[7.5-12.5]h比16[13.5-18.5]h，分别,P=0.008)。肛门周围浸润组的纳布啡的给药频率和总剂量明显更高（分别为P=0.003和0.013）。术后骶管阻滞组的镇静评分明显高于对照组。
■对于接受TERPT手术的儿科患者，就术后镇痛的持续时间而言，肛门周围浸润的效果低于尾部阻滞。然而,两种技术在术后前6小时具有可比性.
■这项随机试验包括60名男女患者，年龄6至18个月，在全身麻醉下接受TERPT手术。患者被随机分为两组，分别接受肛门周围浸润或在0.5ml生理盐水中使用1ml/kg布比卡因0.25％和1µg/kg右美托咪定的尾部阻滞。主要结局是首次抢救镇痛的时间。次要结果是总消费量，24小时内纳布啡作为抢救镇痛的频率和术后镇静水平。
■肛门周围浸润组与尾部阻滞组相比，首次抢救镇痛时间明显缩短（中位数[四分位距]10[7.5-12.5]h比16[13.5-18.5]h，分别,P=0.008)。肛门周围浸润组的纳布啡的给药频率和总剂量明显更高（分别为P=0.003和0.013）。术后骶管阻滞组的镇静评分明显高于对照组。
■对于接受TERPT手术的儿科患者，就术后镇痛的持续时间而言，肛门周围浸润的效果低于尾部阻滞。然而,两种技术在术后前6小时具有可比性.
