摘要
目的观测新生儿术后静脉恒速持续输注等效量舒芬太尼、芬太尼两药对新生儿镇痛的临床效果。方法将90例新生儿随机均分为三组:舒芬太尼组(A组)、芬太尼组(B组)、无镇痛组(C组)。A、B组患儿术后分别采用舒芬太尼0.025μg.kg-1.h-1和芬太尼0.25μg.kg-1.h-1静脉恒速持续输注48 h进行镇痛,C组不用镇痛药。于术后12、24、48、96 h分别行镇痛评分(CRIES评分)和神经行为评分(NBNA评分),同时采集患儿尿标本检测S100β蛋白含量。结果术后各时点C组CRIES分值均高于A、B组(P<0.05);术后48、96 h B组CRIES分值高于A组(P<0.05)。C组NBNA评分明显低于A、B组(P<0.05)。各时点C组尿S100β蛋白含量均明显高于A组和B组(P<0.01),术后48 h和96 h B组尿S100β蛋白含量高于A组(P<0.05)。B组术后恶心呕吐2例,C组5例。各组均无呼吸抑制发生。结论应用上述剂量的舒芬太尼和芬太尼皆能安全有效进行新生儿术后镇痛。
Objective To evaluate the efficacy of postoperative analgesia with sufentanil or fentanyl in neonates. Methods Ninety neonates underwent surgery were randomly divided into 3 groups with 30 cases each. Group A and B recived continuous intravenous infusion of sufentanil（0. 025 μg·kg^-1·h^-1） and fentanly（0.25 μg·kg^-1·h^-1）,respectively. Control group（C） was given no analgesia. Heart rate（ HR）, blood pressure（ BP）, respiratory rate（ RR）, oxygen saturation（ SaO2 ）, pain score（CRIES）, neonatal behavioral neurological assessment （NBNA）were monitored and assessed during analgesia ,and urinary S100β protein concentration of all neonates was measured at 12 h（T1 ） ,24 h（T2）,48 h （T3） and 96 h （T4） after operation. Results Compared to group C, the CRIES was increased significantly at T, to T4 in group A and B（P〈0. 05）. The CRIES was higher significantly in group Bthan that in group Aat T4（P〈0.05）. The NBNAof group A andBwas higher significantly at T1 to T4 than that of group C （P〈0.05）. Urinary S100β protein concentration of group C was higher than that of group A at T1 to T4 （P〈0.01） ,which was higher in group B than that in group A at T2. PONV happened in 2 cases in group B and 5 cases in group C. There were no neonates with respiratory depression in three groups. Conclusion Neonates postoperative analgesia with intravenous sufentanil （0.025μg·kg^-1·h^-1） or fentanyl （0.25 μg·kg^-1·h^-1） is effective and safe.
出处
《临床麻醉学杂志》
CAS
CSCD
2008年第2期120-122,共3页
Journal of Clinical Anesthesiology
关键词
术后镇痛
舒芬太尼
芬太尼
Postoperative analgesia Sufentanil
Fentanyl
