Effect Of Sacral Block Combined With Ibuprofen Suppository On Postoperative Analgesia In Children

Objective: To investigate the effect of multimodal analgesia of sacral block combined with ibuprofen in children after operation.Methods: From January 1,2020 to July 31,2020,80 children aged from 1 to6 years,ASA I ～ II,underwent lower abdominal and perineal surgery in our hospital.There were 30 cases of unilateral indirect hernia with hydrocele,30 cases of unilateral indirect hernia with cryptorchidism and 20 cases of concealed penis.Grouping: 30 cases of unilateral indirect hernia with hydrocele were randomly divided into group B and group D,15 cases in each group;30 cases of unilateral indirect hernia with cryptorchidism were randomly divided into group B and group D,15 cases in each group;20 cases of concealed penis were randomly divided into group B and group D,10 cases in each group.There were 40 cases in Group B and D.Group B was treated with ibuprofen suppository for single analgesia,and group D was treated with sacral block combined with ibuprofen suppository for multimodal analgesia.After entering the operating room,the children underwent ECG monitoring,Sp O2 and blood pressure monitoring.Two groups of children were treated with simple intravenous induction,intravenous injection of midazolam,sufentanil,propofol,cisatracurium.Endotracheal intubation was performed after sufficient oxygen supply.Group D received sacral block before skin incision after intubation.Both groups were treated with propofol combined with remifentanil until the end of operation.At the end of the operation,both groups were given ibuprofen to embolize the anus.Keep the endotracheal intubation and send it to the recovery room for resuscitation and extubation.After returning to the ward,if the children have severe pain,they can add ibuprofen to embolize the anus.The dose is the same as that of the first time,but the interval between the two times should not be less than 4 hours.Statistical indicators:(1)Age,Height and Weight(2)Operation time,Extubation time(3)HR,MAP and Sp O2 were measured before operation(T1),during skin incision(T2)and after operation(T3)(4)Wong Baker facial expression scale score,agitation score and Ramsay Sedation score were measured 30 min,5 h and 24 h after extubation(5)The number of children with additional ibuprofen suppository after operation(6)Postoperative adverse reactions.Results:(1)there was no significant difference in age,height and weight between the two groups(P > 0.05).(2)There was no significant difference in operation time and extubation time between the two groups(P > 0.05).(3)There was no significant difference in MAP and HR before operation(T1)between the two groups(P > 0.05).In group B,MAP and HR increased at the time of skin incision(T2)and at the end of operation(T3)compared with preoperative(T1),and the difference was statistically significant(P < 0.05).In group D,there was no significant difference in MAP and HR at the time of skin incision(T2)and at the end of operation(T3)compared with preoperative(T1)(P > 0.05).At the time of skin incision(T2)and the end of operation(T3),MAP and HR in group B were higher than those in group D(P < 0.05).(4)The scores of Wong Baker facial expression scale and agitation at 30 minutes,5 hours and 24 hours after extubation in group B were higher than those in group D(P < 0.05).(5)The Ramsay Sedation scores of 30 minutes,5 hours and 24 hours after extubation in group D were closer to 2,and the sedation effect in group D was more appropriate.(6)The number of postoperative nausea and vomiting in group B was more than that in Group D.(7)The number of additional cases of ibuprofen suppository in group B was more than that in Group D.Conclusion: The application of sacral block combined with ibuprofen suppository in the operation of lower abdomen and perineum under general anesthesia has satisfactory postoperative analgesia,less agitation,appropriate sedative effect and low incidence of nausea and vomiting.