Low Concentration of Caudal Bupivacaine for Postoperative Analgesia in Elective Pediatric Surgery

以低濃度Bupivacaine尾椎麻醉控制小兒手術後疼痛

石明煌(Ming-Hwang Shyr) ； 黃潔文(Teresa K.M. Wong) ； 陳豐熙(Feng-Shi Chen) ； 陳克章(Hut-Chang Chan) ； 譚培炯(Peter P.C. Tan)

《Acta Anaesthesiologica Sinica》 28卷4期 (1990/12) Pp. 453-458

https://doi.org/10.6955/AAS.199012.0453

摘要

This report summaries our experience in 0.125% bupivacaine caudal analgesia in 70 pediatric patients with age ranging from 3 months to 7 years undergoing routine surgical procedures including herniorrhaphies, orchiopexies, and circumcision. The local anesthetic chosen was 0.125% bupivacaine with epinephrine (1:200,000) being added and the dosage administrated varied from 0.5-1.0 ml/kg depending upon the sites of the surgical procedures. In the recovery room, patients were observed and accessed using the modified scoring system. Patients who achieved a score of four or more during a 30min observation period were given codeine 1 mg/kg intramuscularly and the blocks were rated uneffective. Our result was that 0.125% bupivacaine eaudal analgesia was effective. The rate of success was 79%. The duration of analgesia was 4-8 hours. No delay or difficulty in urination was found. Most of the patients could move their lower extremities but could not bear their weight. Telephone follow-up failed to reveal any analgesia-related complication.

關鍵字

Caudal analgesia: postoperative ； Pediatric ； Pain control ； Bupivacaine

並列摘要

本論文是總結我們使用0.125％bupivacaine尾椎麻醉用於控制小兒手術後疼痛之七十例經驗，病患年齡為三個月到七歲，進行的手術包括疝氣，隱睪，以及包皮等手術，我們使用0.125％bupivacaine加1：200,000 epinephrine的局部麻醉溶液做尾椎止痛;劑量依據不同的手術部位分別給予0.5-1.0 ml / kg。手術後，在恢復室觀察並評估其疼痛的情形，我們使用修改後的Hannallah氏疼痛評分系統作標準，如果病患在恢復室的30分鐘內總分達4分或分以上，我們都給予肌肉注射1 mg / kg的codeine，這次止痛就算失敗結果顯示0.125％bupivacaine尾椎麻醉是有效的，本實驗組的成功率是79％，止痛效果可以持續4到8小時有發現有排尿困難或者延遲排尿的情形，大部分病患在出院時無法自行站立，但可以自己移動雙腿，需要由父母抱回，電話訪視追蹤也没有發現任何與尾椎止痛相關的併發症。