Effect of multimodal analgesia by different ways of preemptive analgesia after laparoscopic surgery in children

Objective To observe the abirritation effect and safety of multimodal analgesia by different ways of preemptive analgesia after laparoscopic surgery in children.Methods 90 patients (5-14 years old,ASA Ⅰ ～ Ⅱ) scheduled for laparoscopic surgery were selected.With a completely randomized and double blind method,they were divided into three groups with 30 patients in each group.Group A received acetaminophen suppository 40 mg/kg by rectal administration after general anesthesia.Group B received transnasal butorphanol 20 μ g/kg after general anesthesia.Group C received an injection of 2 ml saline before the operation.We observed the HR and BP,RR and SPO2,the time of tracheal extubation and residence time of PACU in three groups.Then we recorded VAS score,Ramsay sedation score and adverse reactions of patients.Results The emergence agitation score in group A and B were significantly lower than those in group C (P ＜ 0.01).The Ramsay score in group B was significantly higher than those in group A and C (P ＜ 0.01),and the score in group A was higher than that in group C (P ＜ 0.05).The VAS score of group A and B were significantly lower than that in group C (P ＜ 0.01) 1 and 4 hours after operation,and it was lower than that in group C 8 hours after operation (P ＜ 0.05).The VAS score of group B was lower than that in group A 1,4 and 8 hours after operation (P ＜ 0.05).The first time to press analgesia pump (PCIA) in group C was significantly earlier than those in group A and B (P ＜ 0.01),and the times of press were more significantly than those in group A and B (P ＜ 0.01).Conclusion Both acetaminophen suppository by rectal administration and transnasal butorphanol administration have the same safe and effective preemptive analgesia effect.But the former has less adverse reactions,which is more suitable for application in the primary hospitals. Key words: Preemptive analgesia;  Laparoscopic surgery;  Multimodal analgesia