地佐辛联合曲马多用于学龄前儿童术后镇痛的临床观察

目的：探讨地佐辛联合曲马多用于学龄前儿童骨科手术后静脉镇痛的效果。方法选取2012年6月至2013年10月在我院全身麻醉下行静脉自控镇痛(PCIA)的骨科手术患儿90例，根据随机数字表法随机分为曲马多组(A组)、芬太尼联合曲马多组(B组)、地佐辛联合曲马多组(C组)，每组30例。记录三组患儿术后2 h (T1)、6 h (T2)、24 h (T3)、48 h (T4)的行为学(FLACC)评分、舒适度(BCS)评分和不良反应情况。结果 A组患儿在T1、T2时间点的FLACC评分分别为(3.33±0.84)分、(3.70±0.95)分，均高于B组(2.73±0.91)分、(3.04±0.98)分、C组(2.53±0.57)分、(2.50±0.63)分，差异均有统计学意义(P<0.05)；A组在T1、T2、T3时间点的BCS评分分别为(0.50±0.51)分、(0.80±0.76)分、(0.97±0.49)分，均明显低于B组(1.00±0.79)分、(1.23±0.63)分、(1.47±0.51)分]、C组水平(1.57±0.56)分、(1.37±0.76)分、(1.90±0.67)分]，C组在T1时间点的BCS评分明显高于B组，差异均有统计学意义(P<0.05)；术后不良反应C组(2例)明显低于B组(8例)和A组(10例)，差异均有统计学意义(P<0.05)。结论地佐辛联合曲马多用于学龄前儿童术后静脉镇痛效果好，不良反应发生率低，术后的舒适度更满意，值得临床推广应用。

Effect of dezocine combined with tramadol for analgesia after operation in preschoolers

Objective To investigate the effect of using dezocine combined with tramadol for postoperative an-algesia in preschoolers. Methods Ninety children undergoing orthopedic surgery under patient-controlled intravenous analgesia (PCIA) were selected and divided into three groups according to random number table:ramadol group (group A), fentanyl-tramadol group (group B), dezocine-tramadol group (group C), with 30 patients in each group. The face, legs, activity, cry, consolability (FLACC) score, the Bruggrmann comfort scale (BCS) score and the incidence of ad-verse reactions were collected at 2 hs (T1), 6 hs (T2), 24 hs (T3) and 48 hs (T4) after operation. Results The FLACC score in group A at T1, T2 were (3.33 ± 0.84) and (3.70 ± 0.95) in group A, significantly higher than those in group B (2.73 ± 0.91), (3.04 ± 0.98)] and C (2.53 ± 0.57), (2.50 ± 0.63)], P<0.05. BCS score at T1, T2, T3 were (0.50 ± 0.51), (0.80 ± 0.76) and (0.97 ± 0.49) in group A, which were significantly lower than those in group B (1.00 ± 0.79),(1.23±0.63), (1.47±0.51)], C (1.57±0.56), (1.37±0.76), (1.90±0.67)], P<0.05. The BCS score at T1 in group C was sig-nificantly higher than that in group B (P<0.05). The incidence of adverse reactions in group C (2 cases) was signifi-cantly lower than that in group B (8 cases) and A (10 cases), P<0.05. Conclusion Dezocine combined with tramadol can be widely used for postoperative analgesia in preschoolers, with satisfactory analgesia, less adverse reactions and a high level of comfort.