Email Alerts
RSS
Volume 38 Issue 7
Jul.  2022
Turn off MathJax
Article Contents
Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  > 2022  >  38(7): 683-690
Yang J,Shi S,Wang L,et al.A prospective randomized controlled study on the effects of compound analgesia in ultra-pulsed fractional carbon dioxide laser treatment of post-burn hypertrophic scars in children[J].Chin J Burns Wounds,2022,38(7):683-690.DOI: 10.3760/cma.j.cn501120-20210507-00171.
Citation: Yang J,Shi S,Wang L,et al.A prospective randomized controlled study on the effects of compound analgesia in ultra-pulsed fractional carbon dioxide laser treatment of post-burn hypertrophic scars in children[J].Chin J Burns Wounds,2022,38(7):683-690.DOI: 10.3760/cma.j.cn501120-20210507-00171.
shu

A prospective randomized controlled study on the effects of compound analgesia in ultra-pulsed fractional carbon dioxide laser treatment of post-burn hypertrophic scars in children

doi: 10.3760/cma.j.cn501120-20210507-00171

  • Department of Burns and Cutaneous Surgery, Burn Center of PLA, the First Affiliated Hospital of Air Force Medical University, Xi′an 710032, China

Funds:

Youth Science Foundation Project of National Natural Science Foundation of China 81901965

More Information
  • Corresponding author: Shi Shan, Email: 343351619@qq.com
  • Received Date: 2021-02-21
    Abstract
  •   Objective  To investigate the effects of compound analgesia on ultra-pulsed fractional carbon dioxide laser (UFCL) treatment of post-burn hypertrophic s in children.  Methods  A prospective randomized controlled study was conducted. From April 2018 to March 2020, 169 pediatric patients with post-burn hypertrophic s admitted to the First Affiliated Hospital of Air Force Medical University were randomly divided into general anesthesia alone group (39 cases, 19 males and 20 females, aged 35 (21, 48) months), general anesthesia+lidocaine group (41 cases, 23 males and 18 females, aged 42 (22, 68) months), general anesthesia+ibuprofen suppository group (41 cases, 25 males and 16 females, aged 38 (26, 52) months), and three-drug combination group with general anesthesia + lidocaine+ibuprofen suppository (48 cases, 25 males and 23 females, aged 42 (25, 60) months), and the pediatric patients in each group were treated with corresponding analgesic regimens when UFCL was used to treat s, and the pediatric patients were given comprehensive care throughout the treatment process. The pain degree of pediatric patients scar was evaluated by facial expression,legs,activity,cry,and consolability (FLACC) of children's pain behavior scale at 0 (immediately), 1, 2, and 4 h after awakening from the first anesthesia, respectively. At 4 h after awakening from the first anesthesia of postoperative pain assessment, the self-made analgesia satisfaction questionnaire was used to evaluate the satisfaction for the analgesic effect of the pediatric patients or their families, and the satisfaction rate was calculated. Within 2 h after the first operation, the occurrences of adverse reactions of the pediatric patients, such as nausea and vomiting, headache, dizziness, drowsiness, etc, were observed and recorded. Before the first treatment and 1 month after the last treatment, the Vancouver scar scale (VSS) was used to evaluate the pediatric patients scar, and the difference value between the two was calculated. Data were statistically analyzed with least significant difference test, Kruskal-Wallis H test, chi-square test and Fisher's exact probability test.  Results  At 0 h after awakening from the first anesthesia, the FLACC scores of pediatric patients in general anesthesia+lidocaine group, general anesthesia+ibuprofen suppository group and three-drug combination group were significantly lower than those in general anesthesia alone group (P<0.01). The FLACC scores of the pediatric patients in anesthesia+ibuprofen suppository group and three-drug combination group were significantly lower than that in general anesthesia+lidocaine group (P<0.01), and the FLACC score of the pediatric patients in three-drug combination group was significantly lower than that in general anesthesia+ibuprofen suppository group (P<0.01). At 1 and 2 h after awakening from the first anesthesia, the FLACC scores of pediatric patients in general anesthesia+ibuprofen suppository group and three-drug combination group were both significantly lower than those in general anesthesia alone group and general anesthesia+lidocaine group (P<0.01), and the FLACC score of the pediatric patients in three-drug combination group was significantly lower than that in general anesthesia+ibuprofen suppository group (P<0.01). At 4 h after awakening from the first anesthesia, the FLACC scores of the pediatric patients in general anesthesia+ibuprofen suppository group and three-drug combination group were significantly lower than those in general anesthesia alone group and general anesthesia+lidocaine group (P<0.01). At 4 h after awakening from the first anesthesia, the satisfactions rate with the analgesic effect in the four groups of pediatric patients or their families were 79.49% (31/39), 85.37% (35/41), 87.80% (36/41), and 97.92% (47/48), respectively. The satisfaction rate of the pediatric patients in three-drug combination group was significantly higher than those in general anesthesia alone group, general anesthesia+lidocaine group, general anesthesia+ibuprofen suppository group. Within 2 h after the first operation, there was no significant difference in the overall comparison of adverse reactions such as nausea and vomiting, headache, dizziness, and drowsiness of pediatric patients among the 4 groups (P>0.05). The VSS scores of pediatric patients before the first treatment, 1 month after the last treatment, and and the difference value between the two in the 4 groups were not significantly different (P>0.05).  Conclusions  Three-drug combination for analgesia has a good effect in the treatment of hypertrophic scars after burn in pediatric patients with UFCL. Pediatric patients or their families are highly satisfied with the effect, and the treatment effect and incidence of adverse reactions are similar to other analgesic regimens, so it is recommended to be promoted in clinical practice.

     

    • FullText(HTML)
  • loading
    • References(37)
  • [1]
    李娜, 杨丽, 程静, 等. 脉冲染料激光精细治疗增生性瘢痕的临床研究[J].中国医师杂志,2019,21(4):485-488,494. DOI: 10.3760/cma.j.issn.1008-1372.2019.04.002.
    [2]
    ConnollyKL, ChaffinsM, OzogD. Vascular patterns in mature hypertrophic burn scars treated with fractional CO2 laser[J]. Lasers Surg Med, 2014,46(8):597-600. DOI: 10.1002/lsm.22271.
    [3]
    NarsinghaniU, AnandKJ. Developmental neurobiology of pain in neonatal rats[J]. Lab Anim (NY), 2000,29(9):27-39. DOI: 10.1038/5000089.
    [4]
    孙光祥, 黎志宏. 布洛芬超前镇痛在儿童膝关节镜手术中的应用研究[J].临床小儿外科杂志,2010,9(4):281-283. DOI: 10.3969/j.issn.1671-6353.2010.04.013.
    [5]
    NoelM, ChambersCT, McGrathPJ, et al. The role of state anxiety in children's memories for pain[J]. J Pediatr Psychol, 2012,37(5):567-579. DOI: 10.1093/jpepsy/jss006.
    [6]
    张月嵘, 陈劼, 万园园, 等. 小儿围术期镇痛管理现状及效果研究[J].护士进修杂志,2019,34(16):1441-1444. DOI: 10.16821/j.cnki.hsjx.2019.16.001.
    [7]
    World Health OrganizationWHO normative guidelines on pain management: Report of a Delphi Study to determine the need for guidelines and to identify the number and topics of guidelines that should be developed by WHO2007-10-162020-11-15https://m.doc88.com/p-9149413251101.html?r=1

    World Health Organization. WHO normative guidelines on pain management: Report of a Delphi Study to determine the need for guidelines and to identify the number and topics of guidelines that should be developed by WHO[EB/OL].(2007-10-16)[2020-11-15].https://m.doc88.com/p-9149413251101.html?r=1.
    [8]
    倪思利, 甘立强, 王华, 等. 复方利多卡因乳膏缓解激光治疗儿童血管瘤术中疼痛的临床分析[J].儿科药学杂志,2011,17(4):27-28.
    [9]
    张广源, 索生红, 杨森林. 布洛芬用于儿童和青少年骨折镇痛的效果和安全性:系统评价和Meta分析[J].国际麻醉学与复苏杂志,2018,39(7):650-657. DOI: 10.3760/cma.j.issn.1673-4378.2018.07.009.
    [10]
    李娜, 杨丽, 程静, 等. 脉冲染料激光与超脉冲点阵二氧化碳激光治疗烧伤后增生性瘢痕的临床对比研究[J].中华烧伤杂志,2018,34(9):603-607. DOI: 10.3760/cma.j.issn.1009-2587.2018.09.009.
    [11]
    刘小加, 罗明灿. 二氧化碳点阵激光治疗痤疮瘢痕的护理体会[J].中国美容医学,2016,25(9):110-112.
    [12]
    杨丽娜, 陈烨, 李丽丽, 等. 手术室护理与病房护理相衔接的护理模式在重型颅脑损伤患者中的应用[J].中国医药导报,2020,17(16):186-189.
    [13]
    徐嘉莹, 宋锴澄, 易杰, 等. 国外日间手术麻醉术前评估的新进展[J].中国卫生质量管理,2018,25(4):10-13. DOI: 10.13912/j.cnki.chqm.2018.25.4.04.
    [14]
    张艳, 王丹丹, 李宏丽, 等. 缩短术前禁食水时间对胃癌患者术后胰岛素抵抗的影响[J].中国临床研究,2019,32(1):130-132. DOI: 10.13429/j.cnki.cjcr.2019.01.033.
    [15]
    赵雪娇, 许敏, 胡嘉乐, 等. 国外护士参与麻醉前评估门诊研究现状及对我国的启示[J].中国护理管理,2018,18(9):1289-1292. DOI: 10.3969/j.issn.1672-1756.2018.09.030.
    [16]
    HenryTW, MatzonH, McEnteeR, et al. The clinical impact of ambient operating room temperature and other perioperative factors on patient comfort during wide-awake hand surgery using local anesthesia[J]. Arch Bone Jt Surg, 2021,9(1):110-115. DOI: 10.22038/abjs.2020.44850.2228.
    [17]
    刘明, 陈利琴, 郑佳丽. 儿童疼痛行为量表在唇腭裂患儿术后疼痛评估中的应用及其信效度[J].解放军护理杂志,2012,29(13):20-22,26. DOI: 10.3969/j.issn.1008-9993.2012.13.006.
    [18]
    毋婷. 强脉冲光及激光治疗面部痤疮瘢痕后生活质量及护理满意度分析[J].内蒙古医学杂志,2017,49(11):1392-1394. DOI: 10.16096/J.cnki.nmgyxzz.2017.49.11.054.
    [19]
    梁新蕊, 张玲娟, 冯苹, 等. 无菌生物护创膜在小儿浅Ⅱ度烧伤换药疼痛管理中的应用效果[J].解放军护理杂志,2013,30(14):70-71. DOI: 10.3969/j.issn.1008-9993.2013.14.027.
    [20]
    吴巍巍,刘淑梅,贺婷婷,等.虚拟现实技术在烧伤疼痛干预中的研究进展[J].中华烧伤杂志,2020,36(7):620-622.DOI 10.3760/cma.j.issn.1009-2587.2020.07.103.
    [21]
    王凤乔, 庄蕾, 张富军. 儿童疼痛记忆的研究进展[J].上海交通大学学报(医学版),2021,41(4):546-549. DOI: 10.3969/j.issn.1674-8115.2021.04.022.
    [22]
    NoelM, RosenbloomB, PavlovaM, et al. Remembering the pain of surgery 1 year later:a longitudinal examination of anxiety in children's pain memory development[J]. Pain,2019,160(8):1729-1739. DOI: 10.1097/j.pain.0000000000001582.
    [23]
    NoelM, RabbittsJA, TaiGG, et al. Remembering pain after surgery: a longitudinal examination of the role of pain catastrophizing in children's and parents' recall[J]. Pain, 2015,156(5):800-808. DOI: 10.1097/j.pain.0000000000000102.
    [24]
    罗婷. 小儿疼痛的评估及护理干预[J].中国保健营养,2015(7):4-5.
    [25]
    KliftoKM, AsifM, HultmanCS. Laser management of hypertrophic burn scars: a comprehensive review[J/OL]. Burns Trauma, 2020,8:tkz002[2022-04-01]. https://pubmed.ncbi.nlm.nih.gov/32346540/.DOI: 10.1093/burnst/tkz002.
    [26]
    章一新, 张书诺. A型肉毒毒素在瘢痕治疗中的临床应用及机制探讨[J].中华烧伤杂志,2021,37(8):705-710. DOI: 10.3760/cma.j.cn501120-20210701-00232.
    [27]
    王多友, 程守权. 小儿疼痛治疗:疼痛性记忆与记忆性疼痛[J].医学与哲学,2015(5):21-23,31.
    [28]
    何美媛, 吕小平. 地佐辛在全麻恢复初期镇痛中的临床应用与疗效观察[J].中国伤残医学,2013(11):128-129. DOI: 10.3969/j.issn.1673-6567.2013.11.103.
    [29]
    田皇华, 王双华, 赵超, 等. 右美托咪定复合七氟烷喉罩全麻在小儿斜疝修补术中的应用[J/CD].中华疝和腹壁外科杂志:电子版,2020,14(5):539-543. DOI: 10.3877/cma.j.issn.1674-392X.2020.05.019.
    [30]
    李平, 王健, 罗林丽, 等. 七氟烷吸入诱导麻醉的研究进展[J].华西医学,2017,32(7):1112-1115. DOI: 10.7507/1002-0179.201508176.
    [31]
    杨红伟, 杨倩倩, 刘德成. 复方利多卡因乳膏致角膜损伤的修复探讨[J].中国美容医学,2017,26(11):15-16.
    [32]
    谭启明. 复方利多卡因乳膏应用于无痛护理的研究进展[J].中华现代护理杂志,2013,19(26):3302-3304. DOI: 10.3760/cma.j.issn.1674-2907.2013.26.055.
    [33]
    李强, 胡华琨, 叶玲玲, 等. 布洛芬注射液用于腹腔镜下腹股沟斜疝修补术患儿术后镇痛的效果[J].临床麻醉学杂志,2021,37(4):360-363. DOI: 10.12089/jca.2021.04.006.
    [34]
    焦凤娟. 布洛芬栓塞肛与布洛芬混悬液口服治疗小儿发热的效果比较[J].中外医学研究,2013(32):158-158,159. DOI: 10.3969/j.issn.1674-6805.2013.32.111.
    [35]
    SheckterCC, StewartBT, BarnesC, et al. Techniques and strategies for regional anesthesia in acute burn care-a narrative review[J/OL]. Burns Trauma, 2021,9:tkab015[2022-04-02]. https://pubmed.ncbi.nlm.nih.gov/34285927/. DOI: 10.1093/burnst/tkab015.
    [36]
    赵恒娣, 郝雪莲, 王莉, 等. 烧伤患儿术后盐酸右美托咪定复合镇痛对感染的影响[J].中华医院感染学杂志,2016,26(5):1149-1151. DOI: 10.11816/cn.ni.2016-152165.
    [37]
    李灵匀, 李铁男. 银屑病药物治疗新进展[J].辽宁药物与临床,2003,6(1):7-8. DOI: 10.3969/j.issn.1673-0070.2003.01.004.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(2)  / Tables(5)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (690) PDF downloads(55) Cited by()
    Proportional views
    Related

    Copyright © Chinese Journal of Burns京ICP备07035254号-14

    E-mail：shaoshangzazhi@163.com

    Website：https://zhsszz.xml-journal.net/

    Supported by: Beijing Renhe Information Technology Co. Ltd    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return