关键词: 罗哌卡因, 地佐辛, 多模式镇痛, 唇裂修复术, 术后镇痛

Abstract:

Objective: To discuss the postoperative analgesia efficacy of multimodal analgesia of ropivacaine combined with dezocine,and to illuminate the feasibility of multimodal analgesia in the children undergoing cheiloplasty. Methods: In the randomized,controlled and double blind study,sixty children scheduled for cheiloplasty were randomly divided into ropivacaine group, dezocine group and multimodal analgesia group(n=20). The children in ropivacaine group and multimodal analgesia group were treated with infraobital nerve blockade(1.5 mL 0.25% ropivacaine) before skin incision. The children in dezocine group received the same volume of normal saline. The patients in dezocine group and the multimodal analgesia group received dezocine(0.15 mg·kg^-1)20 min before the end of operation,and the children in ropivacaine group received the same volume of normal saline. The children's ages and weights,duration of anesthesia and operation,reviving and extubation time,agitation score and incidence,laryngospasm or bronchospasm,CRIES scores at 2,4,6,8,12,and 24 h after operation and adverse reactions were all recorded. Results: There were no significant differences in the age,weight,the duration of anesthesia and operation of the children between three groups (P > 0.05). Compared with ropivacaine group,the reviving and extubation time of the children in dezocine group and multimodal analgesia group were increased (P < 0.05). There were no significant differences in the scores and the incidence of agitation between three groups (P > 0.05).There were no laryngospasm or bronchospasm occured in all groups. The CRIES score at 2 h after operation of the children in multimodal analgesia group was the lowest and there were significant differences compared with other two groups (P < 0.05). The CRIES score at 4 h after operation of dezocine group was increased compared with 2 h after operation and was higher than other two groups (P < 0.05). The CRIES score at 6 h after operation of the children in multimodal analgesia group was yet the lowest,and there were significant differences compared with other two groups (P < 0.05). The CRIES score at 6 h after operation of the children in ropivacaine group was also increased,but there was no significant difference compared with dezocine group (P > 0.05). There were no significant differences in the CRIES scores at 8,12,and 24 h after operation between three groups(P > 0.05). Compared with other two groups,the incidence of tachycardia and the cases using analgesic in multimodal analgesia group were the lowest,and there were significant differences compared with other two groups (P < 0.05). There was no respiratory inhibition in all groups. Conclusion: The multimodal analgesia of ropivacaine combined with dezocine can effectively prolong the postoperative analgesia duration and reduce adverse reactions,and it can be safely used in the postoperative analgesia in the children undergoing cheiloplasty.

Key words: ropivacaine, dezocine, multimodal analgesia, cheiloplasty, postoperative analgesia