서혜부탈장 환아의 술 후 통증관리

Abstract

Background: Postoperative pain control in children is an important problem for management but it was treated negligently. In the past, the pain was undertreated in children, even more in infant. In recent years, the importance of the pain control in children was emphasized but not enough, yet. This study was designed to evaluate the propriety of intraoperative intravenous medication technique and effectiveness of the fentanyl, ketorolac and ketamine for pain control following inguinal herniorrhaphy in pediatric patients. Methods: Eighty children for inguinal herniorrhaphy under general anesthesia were divided into four groups. Group I received no analgesics as a control. Group II, III and IV were received intravenous fentanyl 1mug/kg, ketorolac 1 mg/kg and ketamine 1 mg/kg respectively. Fentanyl and ketolorac were injected intravenously during the induction of anesthesia and ketamine was injected at the entrance of operating room. Emergence time and the degree of pain was evaluated. Results: Our result showed that group II and group III had a lower pain score than that of the control group at the 5 min, 10 min, 20 min and 30 min in the recovery room (P < 0.05), but no significant differences were found between the group I and group IV. The time interval from the end of operation to extubation was prolonged in the group II compared to the control group (P < 0.05). But no significant differences were found between the three groups. Conclusions: We suggest that intravenous administration of analgesics has the propriety of the control of postinguinal herniorraphy pain in children. Intravenous administration of fentanyl 1mug/kg and ketorolac 1 mg/kg during induction would be an easy, simple and effective means for relieving postinguinal herniorrhaphy pain in recovery room