国际麻醉学与复苏杂志   2015, Issue (12): 8-8
    
术前心理干预对小儿漏斗胸矫正术后镇痛效应的影响
李俊1()
1.泰山医学院附属
The effect of Preoperative psychological intervention on Children with Funnel Chest Diorthosis for children with funnel chest corrective.
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摘要:

摘要 目的:研究术前心理干预联合静脉镇痛对小儿漏斗胸矫正术后镇痛的效果的影响。方法: 选择40例漏斗胸矫正术患儿,患儿除漏斗胸外,无其他系统器质性疾病,采用随机数字表法分为两组。Ⅰ心理干预组(组Ⅰ):术前予于患儿心理干预。Ⅱ对照组(组Ⅱ):常规围术期准备。两组于手术结束前30min启用电子自控镇痛泵,持续泵入芬太尼量为5μg•kg-1d-1,2ml/h,锁定时间为15min,输注48h,分别于术后1、6、12、24、36及48h记录如下数据:镇静评分采用警觉/镇静评分(OAA/S),疼痛评分,同时记录术后按压次数及相关不良反应。结果: Ramsay镇静评分Ⅰ组明显高于Ⅱ组(p<0.05), FLACC评分Ⅰ组明显低于Ⅱ组(p<0.05)。术后48h芬太尼总用量Ⅰ组(9.6±2.0)μg•kg-1显著少于Ⅱ组(13.8±2.2)μg•kg-1(p<0.05)。按压次数及有效次数显著组Ⅱ(7.9±1.7)次多于Ⅰ组(4.8±1.5)次(p<0.05)结论:术前心理干预可提高小儿漏斗胸矫正术后镇痛效果,增强患儿对术后疼痛的耐受性,促进患儿顺利康复。

关键词: 心理干预 小儿 术后镇痛
Abstract:

[Abstract] Objective: Study of psychological intervention combined intravenous analgesia effects on children postoperative analgesia effect. Methods: Choose 40 cases of children with funnel chest orthotics, children in addition to the funnel chest, no other organic diseases, controlled analgesia pump was opened in 30 min before the end of the operation and continued infusing for 48 hours, respectively in postoperative 1, 6, 12, 24, 36 and 48 h record the These patients were divided into two groups Randomly.Ⅰpsychological intervention group (groupⅠ): children in groupⅠrecieved preoperative psychological intervention. Ⅱcontrol group (group Ⅱ) : Children in groupⅡ recieved conventional perioperative preparation. Two groups in 30 min before the end of surgery used electronic controlled analgesia pump , continuous pumping volume was 5μg•kg-1d-1and 2ml/h, locking time was 15 min, infusion continued 48h. Alert/sedation score (OAA/S) and pain score were used, and records related to postoperative adverse reactions. Results: Ramsay sedation scores in groupⅠis significantly higher than Ⅱ group (p <0.05), Ⅰgroup was lower than that in group Ⅱ FLACC score (p<0.05). total dosage of fentanyl in 48 h groupⅠ(9.6±2.0)μg•kg-1was significantly less than groupⅡ(13.8±2.2)μg•kg-1 (p < 0.05). groupⅡ(7.9±1.7)in pressing times was significantly more than groupⅠ(4.8±1.5)(p< 0.05).Conclusion: preoperative psychological intervention can improve the effect of children with funnel chest corrective postoperative analgesia, enhance children for postoperative pain tolerance, promote patients recover smoothly

Key words: psychological intervention, children postoperative analgesia