Clinical application of tramadol combined with erector spinal muscle plane block in preventing emergence agitation after pediatric abdominal surgery
- VernacularTitle:曲马多联合竖脊肌平面阻滞预防小儿腹部手术后苏醒期躁动的临床应用
- Author:
Hui-ying ZHANG
1
;
Yan CAO
1
Author Information
- Publication Type:Journal Article
- Keywords: tramadol; ultrasound-guided erector spinal muscle plane block; pediatric anesthesia; emergence agitation during awakening period; multimodal analgesia; enhanced recovery after surgery
- From: Journal of Regional Anatomy and Operative Surgery 2025;34(8):719-724
- CountryChina
- Language:Chinese
- Abstract: Objective To explore the application effects of tramadol combined with ultrasound-guided erector spinal muscle plane block in preventing emergence agitation and accelerating surgical rehabilitation after abdominal surgery in pediatric patients.Methods A total of 90 pediatric patients who underwent elective abdominal surgery were randomly divided into tramadol group(Group T),tramadol combined with erector spinal muscle plane block group(Group TE)and blank control group(Group C),with 30 cases in each group.Pediatric patients in Group T were given intravenous tramadol 1 mg/kg 10 minutes after anesthesia induction,pediatric patients in Group TE were given intravenous tramadol 1 mg/kg and erector spinal muscle plane block 10 minutes after anesthesia induction,while pediatric patients in Group C were treated without any drug or nerve block.The vital signs after entry(T0),immediately after surgery(T1),30 minutes after surgery(T2),1 hour after surgery(T3),6 hours after surgery(T4),and 12 hours after surgery(T5)of pediatric patients in the three groups were compared.The adverse reactions related to tramadol and erector spinal muscle plane block of pediatric patients in the three groups were counted.Thirty minutes after surgery,the degree of emergence agitation of pediatric patients in the three groups was evaluated by pediatric anesthesia emergence delirium scale(PAED),and the pain of pediatric patients in the three groups was evaluated by face,legs,activity,cry,consolability scale(FLACC).The recovery time in post-anesthesia care unit(PACU)and hospitalization time of pediatric patients in the three groups were recorded.Results The PAED score 30 minutes after surgery of pediatric patients in Group TE was significantly lower than those in Group T and Group C(P<0.05),and those in Group T was also lower than those in Group C(P<0.001).The FLACC scores 30 minutes after surgery of pediatric patients in Group T and Group TE were lower than that in Group C(P<0.001).The recovery time in PACU of pediatric patients in Group TE was shorter than those in Group T and Group C(P<0.05),and the recovery time in PACU of pediatric patients in Group T was shorter than that in Group C(P<0.05);The hospitalization time of pediatric patients in Group TE was shorter than that in Group T(P<0.05),but there was no statistically significant difference in hospitalization time between Group T and Group C(P>0.05).From T1 to T5,the mean arterial pressures(MAP)of pediatric patients in Group TE were lower than those in Group C(P<0.001),and from T2 to T3,the MAPs of pediatric patients in Group TE were lower than those in Group T(P<0.05);The heart rate(HR)at T1 of pediatric patients in Group TE was lower than that in Group C(P=0.014),and the HR at T5 of pediatric patients in Group T was lower than that in Group C(P=0.025).All children's vital signs were generally controllable.There was no statistically significant difference in the incidence of adverse reactions among the three groups of pediatric patients(P>0.05).Conclusion Tramadol combined with ultrasound-guided erector spinal muscle plane block has a better analgesic effect in abdominal surgery of pediatric patients,with less emergence agitation of general anesthesia,which can stabilize perioperative physiological indexes and control the risk of complications,and accelerate the surgical rehabilitation of pediatric patients.
