摘要
目的探讨不同剂量舒芬太尼静脉持续输注用于小儿术后镇痛的效应。方法择期腹部手术患儿60例,随机分为三组,每组20例,ASAⅠ或Ⅱ级,静吸复合全身麻醉。缝合皮肤时接镇痛泵:Ⅰ组舒芬太尼0.8μg·kg-1.d-1;Ⅱ组1.0μg·kg-1·d-1;Ⅲ组1.2μg·kg-1.d-1。以2ml/h恒速静脉输注,观察术毕、术后4、8、12、24、48hHR、MAP、SpO2、RR、镇痛评分、镇静评分及不良反应。结果60例患儿均完成了48h术后镇痛。镇痛评分:与Ⅱ组和Ⅲ组比较,Ⅰ组各时段评分增加(P<0.05),差异有统计学意义;与Ⅲ组比较,Ⅱ组各时段评分差异无统计学意义(P>0.05)。镇静评分:与Ⅰ组和Ⅱ组比较,Ⅲ组各时段评分增加(P<0.05),差异有统计学意义;与Ⅱ组比较,Ⅰ组各时段评分差异无统计学意义(P>0.05)。HR、MAP、RR:与Ⅱ组和Ⅲ组比较,Ⅰ组在术后4、8、12、24、48h均升高(P<0.05),差异有统计学意义;SpO2:差异无统计学意义(P>0.05);不良反应:术后恶心、呕吐、瘙痒并发症,与Ⅰ组和Ⅱ组比较,Ⅲ组各时段评分增加(P<0.05),差异有统计学意义。结论舒芬太尼1.0μg·kg-1.d-1静脉持续输注用于小儿术后镇痛效能好,不良反应少,安全可行。
Objective To investigate the effect of intravenous sufentanil infusion in different dosage for postoperative analgesia in child. Methods Sixty ASA Ⅰ -Ⅱ children scheduled to undergo abdominal surgery under general anesthesia were randomly divided into three groups. Group Ⅰ received snfentanil 0.8 μg · kg^-1 · d^-1 i. v. for postoperative analgesia,group Ⅱ received sufentanil 1.0 μg · kg^-1 · d^-1 i.v. ,group Ⅲ received sufentanil 1.2 μg · kg^-1 · d^-1i. vo. Patient - controlled intravenous pump was connected immediately before surgical incision. The infusion rate was 2 ml/h. HR, MAP, SpO2, RR, visual analogue score,sedation score and side effect were recorded at the end of operation and 4,8,12,24 and 48 h after operation. Results All patients accomplished postoperative analgesia. Visual analogue pain scores in group I was significantly higher than group Ⅱ and Ⅲ（ P 〈 0.05 ） , and there was no diference between group Ⅱ and Ⅲ （ P 〉 0.05 ）. Sedation score of group Ⅲ was significantly higher than groupⅡ and Ⅲ（P 〈 0.05 ）, and there was no difference between group Ⅰ and Ⅱ （P 〉0.05）. HR,MAP,RR in group I were significantly higher than group Ⅱ or Ⅲ at 4,8,12,24 and 48 h after operation （P 〈 0.05 ）. No significant difference of SpO2 was found among three groups （ P 〉 0.05 ）. The incidence of postoperative nausea, vomiting and pruritus in group Ⅲ was significantly higher than group Ⅰand Ⅱ （ P 〈 0.05 ）. Conclusions Sufentanil 1.0 μg · kg^-1 · d^-1i. v. can be used for intravenous analgesia in child with satisfactory effect and less side effects.
出处
《医学信息（手术学分册）》
2008年第11期971-973,共3页
Medical Information Operations Sciences Fascicule
关键词
小儿
舒芬太尼
术后镇痛
pediatrics
sufentanil
postoperative analgesia
