Clinical Investigation Of The Postoperative Analgesia With Combination Of Desamethasone And Fentanyl In Children

Objective To investigation the feasibility, safety, effect of postoperativeanalgesia in children with fentanyl combination dexamethasone. To contrast the effectof different dose fentanyl combination dexamethasone used in postoperativeanalgesia in children, to search secure does of fentanly used in postoperativeanalgesia in children. Monitoring blood sugar, to study impact of analgesia anddexamethasone to human body metabolism.Method 45 children (2.5-12 years old, ASAâ… -â…¡. Weight 10-32.5kg, male 30,female 15) undergoing orthopedics surgery who voluntary to enforce postoperativeanalgesia by owner parents were randomly divider into 3 groups, groupâ… ,â…¡andâ…¢.,every group induced 15 cases. Their operation were enforced during 8:00-10:00 am.all patient were picked out exclude all patient with abnormity blood sugar, BT, CT.We introduced the usage and emphasis of PCIA unit, explained the VAS methods tochildren and their parents. The model of PCIA was background infusion does 2ml/hand bolus 3ml with lock time 10 minutes, background infusion does was adjusted to1.5ml/h after postoperation 4h. The maximum does in an hour was 14ml andmaximum does was 100ml. PCIA was performed as soon as junk to be suspendedwhen their operation will be ended. The combination agents for PCIA in these groupswere as follows: in groupâ… , fentanly 15ug/kg,groupâ…¡, fentanly 10ug/kg+dexamethasone150ug/kg. groupsâ…¢, fentanly 15ug/kg+dexamethasone 150ug/kg. all groups addedSodium Chloride to dilute to 100ml, when we visited the patients at 1, 2, 4, 8, 12, 24and 36 hours after operation, recorded MBP, HR, RP and SpO2, undertake analgesiaand clam score, note all patiens' frequency of actuality press, frequency utility pressand frequency of actuality press/ frequency utility press. Record all patiens'consumption of fentanly. Record side effect(nausea vomiting, breath ), follow-upstatus of wound healing, time of nick take out stitches.Result (1) There was no apparent difference in analgesia score and the number of press PCIA in postoperation 1h, 36h. (2) There were apparent difference inanalgesia score postoperative 2, 4, 8, 12.24. (3) There was apparent difference in offentanly consumption among three groups, groupâ… was more than groupâ…¡,â…¢. Therewas no difference betweenâ…¡,â…¢group. (4) There were no respiratory depression anditch of skin among three groups, 2 patients in groupâ… felt nauseant(13.3ï¼…), in groupâ…¡,â…¢, each had 1 patient who felt nauseant (6.7ï¼…). (5) The level of blood sugar wereobviously increased 1 hours after operation, 24 hours after operation they came downbut still higher than the level of preoperation. There were no statistical significancesamong these three groups. There was no infection of incisional wound and defer totake outstitches in all patients.Conclusion 1. Fentanyl combination of desamethasone were safe inanalgesia postoperative in children with PCIA.2. Desamethasone reduced dosage of fentanyl in analgesiapostoperative on children. It was better than simple application fentanyl.3. It is best analgesia postoperative prescription aboutFentany 10ug/kg+ desamethasone150ug/kg used children of less 5 and Fentany15ug/kg+ desamethasone 150ug/kg used children of more 5.