论文部分内容阅读
[目的]探讨舒芬太尼用于小儿术后镇痛的安全性、有效性和最佳剂量。[方法]全麻下行择期腹部手术患儿60例,年龄6～12岁,随机分为3组:Ⅰ组舒芬太尼术后镇痛剂量为1μg·kg-1·d-1,Ⅱ组为1.2μg·kg-1·d-1,Ⅲ组为1.4μg·kg-1·d-1。记录术后4、8、24、48h各时点患儿心率(HR)、平均动脉压(MAP)、呼吸频率(RR)、脉搏血氧饱和度(SPO2)、VAS评分、Ramsay评分,记录PCA按压次数、患儿家长对镇痛的满意度以及呼吸抑制、恶心、呕吐、瘙痒等不良反应。[结果]术后4、8、24hVAS评分Ⅰ组高于Ⅱ、Ⅲ组(P﹤0.05),4、8hRamsay评分Ⅰ组低于Ⅱ、Ⅲ组(P﹤0.05),4hRR、SPO2Ⅲ组低于Ⅰ、Ⅱ组(P﹤0.05),PCA按压次数Ⅰ组高于Ⅱ、Ⅲ组(P﹤0.05),家长对镇痛的满意度Ⅰ组低于Ⅱ、Ⅲ组(P﹤0.05),Ⅲ组恶心发生率高于Ⅰ、Ⅱ组(P﹤0.05)。[结论]持续静脉输注舒芬太尼1.2μg·kg-1·d-1能安全有效地用于小儿术后镇痛,是小儿术后镇痛的最佳剂量。
[Objective] To investigate the safety, efficacy and optimal dosage of sufentanil for postoperative analgesia in children. [Method] Sixty children aged 6-12 years undergoing elective abdominal surgery under general anesthesia were randomly divided into three groups: group Ⅰ sufentanil postoperative analgesic dose of 1μg · kg-1 · d-1, group Ⅱ 1.2μg · kg-1 · d-1 in group Ⅲ and 1.4μg · kg-1 · d-1 in group Ⅲ. The heart rate (HR), mean arterial pressure (MAP), respiratory rate (RR), pulse oxygen saturation (SPO2), VAS score and Ramsay score were recorded at 4,8,24,48h after operation. The number of press, the satisfaction of the parents of children with pain relief and respiratory depression, nausea, vomiting, itching and other adverse reactions. [Results] The IVAS scores at 4, 8 and 24 h after operation were significantly higher in group Ⅰ than those in group Ⅱ and Ⅲ (P <0.05), and the Ramsay scores at 4 and 8 h were lower in group Ⅰ than those in groups Ⅱ and Ⅲ (P <0.05) (P <0.05). The number of PCA pressing in group I was higher than those in group II and III (P <0.05). The satisfaction of parents in analgesic pain in group I was lower than that in group II and III (P <0.05) The incidence was higher than Ⅰ, Ⅱ (P <0.05). [Conclusion] Continuous intravenous infusion of sufentanil 1.2μg · kg-1 · d-1 can be safely and effectively used for pediatric postoperative analgesia, which is the best dose for postoperative analgesia in children.