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首页> 美国卫生研究院文献>Journal of Pain Research >Evaluation of postoperative analgesia in pediatric patients after hip surgery: lumbar plexus versus caudal epidural analgesia
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Evaluation of postoperative analgesia in pediatric patients after hip surgery: lumbar plexus versus caudal epidural analgesia

机译：髋关节手术后小儿患者术后镇痛的评估：腰丛与尾硬膜外镇痛

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>Background:There continues to be focus on the value of regional and neuraxial anesthetic techniques when combined with general anesthesia to improve postoperative analgesia. The reported advantages include decreased postoperative opioid requirements, decreased medication-related adverse effects, decreased hospital length of stay, and increased patient satisfaction. Orthopedic procedures of the hip may be amenable to such techniques as there is significant postoperative pain with the requirement for hospital admission and the administration of parenteral opioids. Given the surgical site, various regional anesthetic techniques may be used to provide analgesia including caudal epidural anesthesia (CEA) or lumbar plexus blockade (LPB).>Purpose: The objective of this study was to assess the effectiveness of LPB versus CEA as an analgesic thechnique for patients undergoing elective hip surgery from the opioid consumption and pain scores perspective.>Patients and methods>: The current study retrospectively reviews our experience with CEA and LPB for postoperative analgesia after hip surgery in the pediatric population. Regional anesthesia technique was reviewed as well as opioid requirements and pain scores.>Results: The study cohort included 61 patients, 29 who received an LPB and 32 who received CEA. No difference was noted in the demographics between the two groups. Intraoperative opioid use was 0.7 (IQR: 0.5, 1.1) mg/kg of oral morphine equivalents (MEs) in the LPB group compared to 0.6 (IQR: 0.5, 0.9) in the CEA group (p=0.479). Postoperative opioid use over the first 48 hrs was 4 (IQR: 1, 6) mg/kg of oral ME in the LPB group, compared to 2 (interquartile range [IQR]: 1, 3) in the CEA group (p=0.103). Over the first 24 hrs after surgery, the median pain score in the LPB group was 5 (IQR: 1–6), compared to 3 (IQR: 0, 5) in the CEA group (p=0.014).>Conclusion: These retrospective data suggest a modest postoperative benefit of CEA when compared to LPB following hip surgery in the pediatric population. Postoperative pain scores were lower in patients receiving CEA; however, no difference in the intraoperative or postoperative opioid requirements was noted between the two groups.
机译：>背景：与全身麻醉相结合以改善术后镇痛效果时，区域和神经轴向麻醉技术的价值仍将继续受到关注。报道的优势包括减少术后阿片类药物的需求，减少与药物相关的不良反应，减少住院时间以及提高患者满意度。髋关节的整形手术可能适合这种技术，因为术后会有明显的疼痛，需要住院和肠胃外注射阿片类药物。根据手术部位，可以使用各种区域麻醉技术来提供镇痛作用，包括尾硬膜外麻醉（CEA）或腰丛神经阻滞（LPB）。>目的：该研究的目的是评估从阿片类药物消耗和疼痛评分的角度来看，LPB与CEA作为行选择性髋关节手术的镇痛方法。>患者和方法 >：本研究回顾性地回顾了我们在CEA和治疗中的经验。 LPB用于小儿髋关节手术后的镇痛。回顾了区域麻醉技术以及阿片类药物的需求量和疼痛评分。>结果：该研究队列包括61例患者，其中29例接受LPB，32例接受CEA。两组之间的人口统计学没有差异。 LPB组术中使用阿片类药物的口服吗啡当量（ME）为0.7（IQR：0.5，1.1）mg / kg，而CEA组为0.6（IQR：0.5，0.9）（p = 0.479）。 LPB组术后48小时口服阿片类药物的口服ME为4（IQR：1、6）mg / kg，而CEA组为2（四分位间距[IQR]：1、3）（p = 0.103） ）。在手术后的最初24小时内，LPB组的中位疼痛评分为5（IQR：1-6），而CEA组的中位疼痛评分为3（IQR：0、5）（p = 0.014）。>结论：这些回顾性数据表明，与小儿髋关节手术后的LPB相比，CEA的术后获益中等。接受CEA的患者术后疼痛评分较低；然而，两组之间的术中或术后阿片类药物需求没有差异。

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