| 摘要: |
| 目的：对比布洛芬混悬液和盐酸曲马多片用于儿童肱骨髁上骨折切开复位内固定术后的镇痛效果。方法：将150例肱骨髁上骨折（Gartland Ⅲ型）切开复位、克氏针内固定的手术患儿随机分为布洛芬组（A组）和曲马多组（B组）各75例。A组麻醉苏醒后每8 h口服布洛芬混悬液1次，维持48 h；B组麻醉苏醒后每8 h口服盐酸曲马多片1次，维持48 h。如服用上述药物仍不能控制疼痛，则口服对乙酰氨基酚混悬液15 mg/kg。第1次服药前、术后1 h、8 h、16 h、24 h、32 h、40 h、48 h、72 h分别用改良面部表情法评估疼痛情况。观察有无恶心、呕吐、嗜睡、头晕、头痛、便秘、瘙痒、药物过敏、呼吸抑制等不良反应等并记录。结果：A组与B组第1次服药前及术后1 h、8 h、16 h、24 h、32 h、40 h、48 h、72 h改良面部表情法疼痛评分比较差异无统计学意义（P>0.05）。A、B组中需要额外给予对乙酰氨基酚混悬液镇痛的病例分别为6例（8%）和9例（12%），两组比较差异无统计学意义（P>0.05）。两组均未发现药物过敏、呼吸抑制的病例。A组中出现不良反应13例（17.3%），B组中出现不良反应27例（36.0%），两组比较差异有统计学意义（P<0.05）。A组中恶心、呕吐、嗜睡、头晕的发生率低于B组，两组比较差异有统计学意义（P<0.05）。结论：布洛芬混悬液用于儿童肱骨髁上骨折切开复位内固定术后镇痛的效果与盐酸曲马多片相当，但不良反应率更低。 |
| 关键词: 布洛芬 曲马多 肱骨髁上骨折 术后镇痛 儿童 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2016.01.004 |
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| 基金项目: |
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| The Post-operative Analgesia Effect of Ibuprofen and Tramadol in Supracondyle Fracture of Humerus in Children |
| Zhu Guanghui, Mei Haibo, Liu Kun, Wu Jiangyan, Tang Jin |
| (Hunan Children’s Hospital, Hunan Changsha 410007, China) |
| Abstract: |
| Objective: To compare the post-operative analgesic effect of ibuprofen suspension and tramadol hydrochloride tablets in supracondyle fracture of humerus in children who were managed by open reduction and internal fixation. Methods: 150 patients with type III supracondyle fracture of humerus who were managed by open reduction and internal fixation were randomly allocated into ibuprofen group (group A) and tramadol group (group B) with 75 cases each. Oral ibuprofen suspension was given to group A in a 8 hours interval for 48 hours after anesthesia recovery while tramadol hydrochloride tablets was given to group B respectively. The Faces Pain Scale-Revised (FPS-R) post-operative 1 h, 8 h, 16 h, 24 h, 32 h, 40 h, 48 h were taken note. Any adverse effect such as nausea, vomiting, drowsiness, dizziness, constipation, headache, abdominal pain, pruritus, respiratory depression or hypersensitivity was also recorded. Results: The FPS-R scores in both groups showed no significant difference before medication, post-operative 1 h, 8 h, 16 h, 24 h, 32 h, 40 h, 48 h and 72 h (P>0.05). The number of cases who needed additional acetaminophen in group A and B were 6 (8%) and 9 (12%), and there is no significant difference between groups (P>0.05). No respiratory depression or hypersensitivity was founded in both groups. The number of cases with adverse effect in group A and B were 13 (17.3%) and 27 (36%). The adverse effect rate in group A is lower than group B with significant difference (P<0.05). The incidence of nausea, vomiting, drowsiness, dizziness in group A is lower than group B with significant difference (P<0.05). Conclusion: For pediatric cases with supracondyle fracture of humerus who were managed by open reduction and internal fixation, the post-operative analgesia effect of ibuprofen suspension is equal to that of tramadol hydrochloride tablets with lower adverse effect. |
| Key words: Ibuprofen Tramadol Supracondyle fracture of humerus Post-operative analgesia effect Children |
