未经证实:疼痛管理在术后设置中是必不可少的,尤其是儿科患者。肋软骨收获后供体部位疼痛严重,特别是在术后早期。本研究旨在探讨超声引导下单次注射肋间神经阻滞(ICNB)作为多模式镇痛的组成部分,用于儿科自体耳廓重建的有效性。
UNASSIGNED:§50名年龄在6-16岁之间并计划进行2次肋骨软骨收获手术的儿科患者被纳入该双盲,前瞻性和随机研究。将儿科随机分为肋间神经阻滞组(B组)和对照组(C组)。B组患者在手术结束时接受曲马多2mg/kg的曲马多2mg/kg作为对照。两组均给予曲马多为主的静脉自控镇痛和抢救镇痛。主要结果是术后早期的疼痛评分(VAS和FLACC量表,4h,和8小时)。次要结果是术后曲马多的消耗量和首次抢救镇痛需求的时间点。
UNASSIGNED:术后4h和8h,B组的VAS评分明显低于C组[2.5(2-5)vs.4(2.5-5.5),4h时p=0.041;3(2.5-4.5)vs.4(3-5)8小时时p=0.047]。与C组相比,B组曲马多总消耗量在8h时明显减少(p<0.01)。12h,24h和48h(p分别<0.05)。阻滞组首次抢救镇痛需求和抢救次数明显低于对照组(p<0.01,p<0.05)。
UNASSIGNED:我们的研究结果表明,超声引导ICNB轻微但显著降低了疼痛评分,与术后4h和8h未接受神经阻滞的儿童患者相比,肋软骨收获后服用曲马多。统一ICNB罗哌卡因剂量可能不利于提供出色的镇痛效果。
UNASSIGNED: ː Pain management is essential in postoperative settings, especially with pediatric patients. Donor site pain after rib cartilage harvest is severe, particularly during the early postoperative period. This study aimed to explore the effectiveness of ultrasound guided single-injection intercostal nerve block (ICNB) as a component of multimodal analgesia for pediatrics undergoing autologous auricular reconstruction.
UNASSIGNED: ː Fifty pediatric patients aged 6-16 years and scheduled for 2 rib cartilages harvest surgery were enrolled in this double-blind, prospective and randomized study. Pediatrics were randomly assigned into two groups: the intercostal nerve block group (group B) and the control group (group C). The nerve block was performed with 2 ml 0.25% ropivacaine each intercostal nerve in group B. Patients from group C received Tramadol 2 mg/kg by the end of the surgery as control. Tramadol-based patient-controlled intravenous analgesia and rescue analgesia were given in both groups. The primary outcome was pain scores at early postoperative period (VAS and FLACC scale, 4 h, and 8 h). The secondary outcome was the postoperative Tramadol consumption and time point of first rescue analgesic demand.
UNASSIGNED: ː VAS score was significantly lower in group B than group C at 4 h and 8 h postoperatively [2.5(2-5) vs. 4(2.5-5.5), p = 0.041 at 4 h; 3(2.5-4.5) vs. 4(3-5), p = 0.047 at 8 h]. Total Tramadol consumption in group B decreased significantly in contrast with group C at 8 h (p < 0.01), 12 h, 24 h and 48 h (p < 0.05, respectively). The first rescue analgesia demand and number of rescue Tramadol in block group was considerably delayed or reduced than control group (p < 0.01, p < 0.05, respectively).
UNASSIGNED: ː Our findings indicated that ultrasound guided ICNB slightly but significantly reduced pain scores, and Tramadol consumption in pediatric patients after rib cartilage harvest as compared to who didn\'t receive nerve block at 4 h and 8 h postoperatively. Unified ICNB ropivacaine dosage might detrimental to providing superior analgesia.