沟通、水化？

The surgeon had planned to give codeine to the patient for postoperative pain control.

What would you recommend to the surgeon for postoperative pain control? According to the 2011 AAO–HNS guideline, it is important to educate the caregiver to communicate with the child about pain severity, pain medications, hydration, regularly scheduled pain medication, rectal administration of acetaminophen if oral medication is refused, and normal pain increase in the mornings [22]. Acetaminophen on a scheduled basis is recommended as first-line post adenotonsillectomy pain treatment. Ibuprofen may be safe as a second line medication, and can be discussed with the surgeon. Ibuprofen should not be given to the dehydrated patient because of concern for renal injury. Hydrocodone and oxycodone can be cautiously administered, but not codeine. The lowest effective dose should be chosen. Any child who is excessively sleepy should not receive opioids [34]. As above, a one time intraoperative dose of dexamethasone reduces postoperative nausea, vomiting, and pain, but may increase postoperative bleeding severity, though not incidence of postoperative bleeding。

1.外科医生原计划给患者注射可待因来控制术后疼痛。你会建议外科医生使用何种药物进行术后镇痛？

根据2011年的AAO-HNS指南，医院应对医护人员进行培训，以保证其与患儿能有效沟通，内容包括疼痛的严重程度、镇痛的药物的类型和选择、水化、拒绝口服药物时的经直肠途径给药，以及疼痛通常在早上会感觉加重等情况[22]。建议将对乙酰氨基酚作为扁桃体切除术后疼痛的一线治疗药物，将布洛芬作为二线药物会是安全的，这可以与外科医生讨论。但是考虑到肾脏损伤，不应给脱水患者服用布洛芬。氢可酮和羟考酮可以谨慎使用，且应选择最低有效剂量，但可待因不能用。任何过度嗜睡的儿童都不该使用阿片类药物[34]。如上所述，术中单次使用地塞米松可减少术后恶心、呕吐和疼痛，但是可能会增加术后出血的严重程度，然而术后出血的发生率并未增加[35]。

 讲扁桃体切除后的镇痛：1.这里的水化指什么？就是指补液吗？也就是说补液也是止痛的一种方法？2.与患儿能有效沟通，内容包括---，你与孩子沟通，孩子能懂这么多内容吗？

麻烦各位老师看一下，帮我解答一下，谢谢