Clinical application of tramadol combined with erector spinal muscle plane block in preventing emergence agitation after pediatric abdominal surgery

ZHANG Hui-ying; CAO Yan

doi:10.11659/jjssx.07E024146

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Clinical application of tramadol combined with erector spinal muscle plane block in preventing emergence agitation after pediatric abdominal surgery

Clinical Research | 更新时间：2025-07-31

- Clinical application of tramadol combined with erector spinal muscle plane block in preventing emergence agitation after pediatric abdominal surgery
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 34, Issue 8, Pages: 719-723(2025)
- 作者机构：
  
  南京医科大学附属妇产医院/南京市妇幼保健院麻醉科，江苏南京 210004
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.07E024146
  CLC： R453.9
- Received：28 July 2024，
  
  Published：25 August 2025
- 稿件说明：
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张卉颖,曹艳.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[J].局解手术学杂志,2025,34(08):719-723.

ZHANG Hui-ying,CAO Yan.Clinical application of tramadol combined with erector spinal muscle plane block in preventing emergence agitation after pediatric abdominal surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(08):719-723.
张卉颖,曹艳.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[J].局解手术学杂志,2025,34(08):719-723. DOI： 10.11659/jjssx.07E024146.

ZHANG Hui-ying,CAO Yan.Clinical application of tramadol combined with erector spinal muscle plane block in preventing emergence agitation after pediatric abdominal surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(08):719-723. DOI： 10.11659/jjssx.07E024146.

摘要

目的

探究曲马多联合超声引导下竖脊肌平面阻滞在预防小儿腹部手术后苏醒期躁动、加速外科康复中的应用效果。

方法

选取行择期腹部手术患儿90例，随机分为曲马多组（T组）、曲马多联合竖脊肌平面阻滞组（TE组）及空白对照组（C组），每组30例。T组患儿麻醉诱导后10 min静脉注射曲马多1 mg/kg；TE组患儿麻醉诱导后10 min静脉注射曲马多1 mg/kg，并行竖脊肌平面阻滞；C组患儿不予任何药物及神经阻滞处理。比较3组患儿入室后（T0）、术后即刻（T1）、术后30 min（T2）、术后1 h（T3）、术后6 h（T4）、术后12 h（T5）的生命体征；统计3组患儿曲马多和竖脊肌平面阻滞相关的不良反应情况；术后30 min，采用小儿麻醉苏醒期躁动评分量表（PAED）评估3组患儿躁动程度，采用面部、腿部、活动、哭泣、可安慰性量表（FLACC）评估3组患儿疼痛情况。记录3组患儿麻醉恢复室（PACU）内恢复时间、住院时间。

结果

TE组患儿术后30 min PAED评分低于T组和C组（

0.05），T组亦低于C组（

0.001）；T组、TE组患儿术后30 min FLACC评分均低于C组（

0.001）。TE组患儿PACU内恢复时间短于T组和C组（

0.05）

T组患儿PACU内恢复时间短于C组（

0.05）；TE组患儿住院时间短于C组（

0.05），但T组和C组患儿的住院时间无统计学差异（

0.05）。T1~T5时，TE组患儿平均动脉压（MAP）低于C组（

0.001），T2~T3时，TE组患儿MAP低于T组（

0.05）；TE组患儿T1时的心率（HR）低于C组（

=0.014），T组患儿T5时的HR低于C组（

=0.025）。所有患儿生命体征均总体可控。3组患儿不良反应发生率比较，差异均无统计学意义（

0.05）。

结论

曲马多联合超声引导下竖脊肌平面阻滞应用于小儿腹部手术的镇痛效果更优，全身麻醉苏醒期躁动的发生更少，实现围术期生理指标稳定与并发症风险可控，加速患儿外科康复。

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 （

0.05）， and those in Group T was also lower than those in Group C （

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 （

0.001）.The recovery time in PACU of pediatric patients in Group TE was shorter than those in Group T and Group C （

0.05）， and the recovery time in PACU of pediatric patients in Group T was shorter than that in Group C （

0.05）；The hospitalization time of pediatric patients in Group TE was shorter than that in Group T（

0.05）， but there was no statistically significant difference in hospitalization time between Group T and Group C （

0.05）. From T1 to T5， the mean arterial pressures （MAP） of pediatric patients in Group TE were lower than those in Group C （

0.001）， and from T2 to T3， the MAPs of pediatric patients in Group TE were lower than those in Group T （

0.05）； The

heart rate （HR） at T1 of pediatric patients in Group TE was lower than that in Group C （

=0.014）， and the HR at T5 of pediatric patients in Group T was lower than that in Group C （

=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 （

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.

关键词

Keywords

references

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