利多卡因气雾剂与注射液联合双氯芬酸钾栓在儿童包皮环切镇痛康复效果比较

doi:10.3969/j.issn.1006-6233.2025.03.030

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摘要 目的: 探究使用利多卡因气雾剂联合双氯芬酸钾栓与采用利多卡因注射液联用双氯芬酸钾栓在镇痛效果及康复质量方面所表现出的差异。方法: 选取2020年7月至2024年3月在我院接受儿童包皮环切术的患儿120例,其中60例使用利多卡因气雾剂联合双氯芬酸钾栓,设为气雾剂组,另外60例使用利多卡因注射液联合双氯芬酸钾栓,设为注射液组,进行前瞻性研究。结果: 两组患儿的年龄、BMI、术后疼痛恢复时长、手术时间在统计学上无明显差异(P>0.05)。气雾剂组麻醉起效时间短于注射液组(t=-11.539,P<0.001)。重复测量方差分析可得,FLACC得分在不同麻醉方式间、不同时点间的差异及麻醉方式与时间的交互作用均有统计学意义(P<0.05);气雾剂组在以上三时点的疼痛评分均显著低于注射液组(P<0.001),且随时间推移(手术开始至结束),疼痛逐渐加剧(P<0.05)。术后气雾剂组出现出血、水肿、感染并发症的例数低于注射液组(χ²=7.063,P<0.05)。重复测量方差分析显示VAS得分在不同麻醉方式间、不同时点间的差异及麻醉方式与时间的交互作用均有统计学意义(P<0.05);气雾剂组术后三时点的VAS得分均值小于注射液组(P<0.001),且得分持续下降(P<0.05)。此外,气雾剂组患儿的住院时间与首次排尿时间均短于注射液组(P<0.001)。结论: 相较于利多卡因注射液与双氯芬酸钾栓的联合使用,利多卡因气雾剂与双氯芬酸钾栓的组合在儿童包皮环切术中及术后展现出更低的疼痛感、更优的镇静效果,还显著减少了术后患儿的并发症发生率,缩短了住院时间以及首次排尿时间。

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	郗琦
	姜斌
	周学武
	雷红林

关键词 ：利多卡因气雾剂, 利多卡因注射液, 双氯芬酸钾栓, 包皮环切术, 镇痛效果

Abstract：Objective: To compare the analgesic efficacy and rehabilitation quality of lidocaine aerosol combined with diclofenac potassium suppository versus lidocaine injection combined with diclofenac potassium suppository in pediatric circumcision. Methods: A total of 120 pediatric patients undergoing circumcision at our hospital from July 2020 to March 2024 were prospectively studied. Patients were divided into two groups: the aerosol group (n=60, lidocaine aerosol combined with diclofenac potassium suppository) and the injection group (n=60, lidocaine injection combined with diclofenac potassium suppository). Age, BMI, postoperative pain recovery time, and surgical duration were compared. Anesthesia onset time, FLACC (Face, Legs, Activity, Cry, Consolability) scores, VAS (Visual Analog Scale) scores, postoperative complications (bleeding, edema, infection), hospitalization time, and first urination time were evaluated. Results: There were no significant differences in age, BMI, postoperative pain recovery time, or surgical duration between the two groups (P>0.05). The aerosol group had a shorter anesthesia onset time compared to the injection group (t=-11.539, P<0.001). Repeated measures ANOVA revealed significant differences in FLACC scores between anesthesia methods, time points, and their interaction (P<0.05). The aerosol group had significantly lower FLACC scores at all time points (P<0.001), with pain increasing over time (P<0.05). The aerosol group also had fewer postoperative complications (bleeding, edema, infection) than the injection group (χ²=7.063, P<0.05). VAS scores showed significant differences between anesthesia methods, time points, and their interaction (P<0.05), with the aerosol group having lower VAS scores at all postoperative time points (P<0.001) and a continuous decline in scores (P<0.05). Additionally, the aerosol group had shorter hospitalization and first urination times compared to the injection group (P<0.001). Conclusion: Compared to lidocaine injection combined with diclofenac potassium suppository, lidocaine aerosol combined with diclofenac potassium suppository provides superior analgesia, better sedation, fewer postoperative complications, and shorter hospitalization and first urination times in pediatric circumcision.

Key words： Lidocaine aerosol Lidocaine injection Diclofenac potassium suppository Circumcision Analgesic effect

基金资助:江苏省卫生健康委科研项目,(编号:Z2020060)

引用本文:

郗琦, 姜斌, 周学武, 雷红林. 利多卡因气雾剂与注射液联合双氯芬酸钾栓在儿童包皮环切镇痛康复效果比较[J]. 河北医学, 2025, 31(3): 514-518.
XI Qi, JIANG Bin, ZHOU Xuewu, et al. Comparison of Analgesic and Rehabilitation Effects Between Lidocaine Aerosol and Injection Combined with Diclofenac Potassium Suppository in Pediatric Circumcision. HeBei Med, 2025, 31(3): 514-518.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.03.030 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I3/514

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