摘要
目的比较舒芬太尼静脉自控镇痛两种方案在儿童漏斗胸Nuss术后的镇痛效果,探讨舒芬太尼在儿童漏斗胸Nuss术后静脉镇痛的有效剂量与方式。方法接受漏斗胸Nuss术的儿童60例,年龄3-12岁。术后采用舒芬太尼持续静脉输注镇痛,按舒芬太尼恒速背景输注剂量的不同分为S1组(n=30)和S2组(n=30),S1组(舒芬太尼,0.06μg·kg^(-1)·h^(-1)+PCA 0.03μg·kg^(-1),锁定时间30min),S2组起始方案同S1组(舒芬太尼0.06μg·kg^(-1)·h^(-1)+PCA 0.03μg·kg^(-1),锁定时间30min);当因疼痛第一次按压PCA后背景输注剂量调节为0.09μg·kg^(-1)·h^(-1)。观察记录两组术后12、24、48、72及96h的疼痛、镇静、情绪、睡眠质量评分,并记录有无恶心、呕吐、呼吸抑制、皮肤瘙痒等不良反应,记录PCA次数,计算单位时间实际用药量,记录患儿或监护人对镇痛的满意度。结果两组术后疼痛评分无明显差异,但S2组较S1组的镇痛满意度高、患儿术后情绪状态好、睡眠质量好(P<0.05),易于为患儿及家属接受,两组术后不良反应轻。结论当镇痛需求高时将舒芬太尼背景输注剂量由0.06μg·kg^(-1)·h^(-1)提高为0.09μg·kg^(-1)·h^(-1)的方式在儿童漏斗胸Nuss术后的镇痛效果好,满意度高。
Objective To compare the efficacy of sufentanil intravenous analgesia with difeerent background infusion doses and ways in children undergoing Nuss surgery. Methods 60 cases of children undergoing Nuss surgery were randomly divided into two groups （group S1 and group S2）,with 30 in each group. All the children received sufentanil infusing for postoperative intravenous analgesia, group S1 （sufentanil 0.06μq·kq^-1·h^-1＋PCA0.03μq·kg^-1 locking time 30min）;group S2 [sufentanil 0.09μq·kq^-1·h^-1 raised from 0.06μq·kq^-1·h^-1＋PCA0.03μq·kg^-1 locking time 30min]. The scores of pain,sedation,emotion,and quality of sleep and the degree of satisfaction were measured at the time points of 12,24,48,72,96h after surgery. The side effects as nausea and vomiting, respiratory depression and titillation were recorded. The actual doses per day and the degree of satisfaction were recorded too. Results Patients in group S2 got lower emotion、sleeping scores and less PCA times than group S1 （P〈0.05）. There was no significant difference between the two groups on pain、sedation and side effects. Conclusion Intravenous infusion of sufentanil in thoracic surgery at the rate of 0.09μq·kq^-1·h^-1 can achieve saisfactory analgesia without more incidence of adverse reactions. Conclusion It was effective to raise the background infusion dose of sufentanil from 0.06 to 0.09μq·kq^-1·h^-1 for postoperative intravenous analgesia in children undergoing Nuss surgery,which achieved high degree of satisfaction.
作者
彭夕华
肖煜
缑海娣
PENG Xihua;XIAO Yi;GAO Haidi(Depatment of A naesthesiology,Jiangxi Children＇s Hospital,Nangchang 330006,China)
出处
《江西医药》
CAS
2018年第8期802-805,共4页
Jiangxi Medical Journal
基金
江西省卫生计生委科技计划
编号20185450
关键词
舒芬太尼
术后镇痛
儿童
NUSS术
Sufentanil
Postoperative analgesia
Children
Nuss surgery
