异丙酚与七氟醚麻醉对小儿腺扁桃体切除术后急性疼痛的控制:一项随机对照试验。

IF 1.7 4区 医学 Q2 ANESTHESIOLOGY
Pediatric Anesthesia Pub Date : 2025-11-01 Epub Date: 2025-09-08 DOI:10.1111/pan.70047
Zhi-Peng Zhong, Yu Gao, Cheng Fan, Xue Bai, Hao Luo, Lei Zhang, Vivian-Min Yuen, Ying-Yi Xu, Xing-Rong Song, Bi-Lian Li
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引用次数: 0

摘要

背景:儿童腺扁桃体切除术后的疼痛是普遍的,往往是严重的,而且往往管理不善。异丙酚或七氟醚麻醉在急性术后疼痛管理中的有效性尚不清楚。方法:采用单盲、随机对照试验,观察异丙酚或七氟醚麻醉的术后镇痛效果。144名2-7岁的儿童被纳入研究,随机分配接受异丙酚或七氟醚麻醉,其中142人完成了研究。主要观察指标是两组患者术后急性疼痛的比例,采用面部、腿部、活动、哭泣和安慰(FLACC)量表在24小时内评分bb0.3。次要结局包括术后1、2、3、7和14天的父母术后疼痛测量(PPPM)量表和数字评定量表(NRS)评估的术后疼痛,以及围手术期不良事件。结果:两组患者24 h内急性疼痛FLACC bbb3的发生率具有可比性(71例中30例[42.3%]vs. 71例中34例[47.9%];优势比[OR] = 0.78, 95%可信区间[CI]: [0.28, 2.18]; p = 0.500)。异丙酚组术后2-3天疼痛评分较高,组间中位数差异(ΔNRS at activity = 1, ΔPPPM = 1)低于最小临床重要差异阈值(ΔNRS > 1, ΔPPPM > 3)。结论:异丙酚维持麻醉和七氟醚维持麻醉患儿在腺扁桃体切除术后24小时内急性疼痛的发生率和强度无显著差异。两种全麻技术在2周内疼痛预后方面表现出相当的临床疗效。试验注册:中国临床试验注册中心(ChiCTR2300075847,注册日期:2023年9月3日)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Propofol Versus Sevoflurane Anesthesia for Acute Postoperative Pain Management in Pediatric Adenotonsillectomy: A Randomized Controlled Trial.

Background: Pain following pediatric adenotonsillectomy is prevalent, frequently severe, and often inadequately managed. The effectiveness of propofol or sevoflurane anesthesia in acute postoperative pain management is unknown.

Methods: We conducted a single-blind, randomized controlled trial to examine the postoperative analgesic effectiveness of propofol or sevoflurane anesthesia. 144 children aged 2-7 years were enrolled and randomly assigned to receive either propofol or sevoflurane anesthesia, with 142 completing the study. The primary outcome was the proportion of acute postoperative pain measured by the Face, Legs, Activity, Cry, and Consolability (FLACC) scale scores > 3 within 24 h between the two groups. Secondary outcomes included postoperative pain assessed by the parent's postoperative pain measure (PPPM) scale and numeric rating scale (NRS) on the 1, 2, 3, 7, and 14 postoperative days, as well as perioperative adverse events.

Results: The incidence of acute pain FLACC > 3 within 24 h showed comparable results between both groups (30 of 71 [42.3%] vs. 34 of 71 [47.9%]; odds ratio [OR] = 0.78, 95% confidence interval [CI]: [0.28, 2.18]; p = 0.500). The propofol group demonstrated higher pain scores on postoperative days 2-3, with between-group median differences (ΔNRS at activity = 1, ΔPPPM = 1) below minimal clinically important difference thresholds (ΔNRS > 1, ΔPPPM > 3).

Conclusions: The incidence and intensity of acute postoperative pain in the first 24 h after adenotonsillectomy did not differ significantly between pediatric patients who received maintenance anesthesia with propofol or with sevoflurane. The two general anesthesia techniques exhibited comparable clinical efficacy with respect to pain prognosis within 2 weeks.

Trial registration: The Chinese Clinical Trial Registry (ChiCTR2300075847, Date of registration: September 3, 2023).

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来源期刊
Pediatric Anesthesia
Pediatric Anesthesia 医学-麻醉学
CiteScore
3.20
自引率
11.80%
发文量
222
审稿时长
3-8 weeks
期刊介绍: Devoted to the dissemination of research of interest and importance to practising anesthetists everywhere, the scientific and clinical content of Pediatric Anesthesia covers a wide selection of medical disciplines in all areas relevant to paediatric anaesthesia, pain management and peri-operative medicine. The International Editorial Board is supported by the Editorial Advisory Board and a team of Senior Advisors, to ensure that the journal is publishing the best work from the front line of research in the field. The journal publishes high-quality, relevant scientific and clinical research papers, reviews, commentaries, pro-con debates, historical vignettes, correspondence, case presentations and book reviews.
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