CAJ | 학술논문

目的观察应用静脉持续泵注芬太尼联合咪唑安定,在小儿先天性心脏病矫治术后镇痛的效果及不良反应.方法选择加例择期行先天性心脏病矫治术婴幼儿随机分为镇痛组和对照组,各20例.镇痛组用芬太尼0.5～2 μg/(kg·h)持续静脉微量泵注入;对照组给予布洛芬5～8 mg/(kg·次).两组均用咪唑安定0.01～0.2 mg/(kg·h)静脉持续微量泵注入或0.05～0.1 mg/(kg·次)间断静脉推注镇静.观察术后2、8、24、48 h的镇静、镇痛效果同时行Ramsay、Comfort评分;观察恶心、呕吐、心率及血压下降、呼吸抑制等的不良反应情况.结果镇痛组和对照组术后2、8、24 h,两组Ramsay、Comfort评分差异显著(P<0.05),而48 h两组Ramsay、Comfort评分无显著差异.镇痛组20例患儿中有1例出现一过性心率减慢、血压下降,数分钟后恢复.未用机械呼吸患儿用药期间未发现呼吸抑制、喉痉挛等不良反应.镇痛组、对照组无恶心、呕吐、消化道出血等不良反应.结论婴幼儿心内直视术后应用芬太尼联合咪唑安定持续静脉泵注在婴幼儿先心术后早期可以达到良好的镇静镇痛效果,安全有效并值得在临床推广.
목적 관찰응용정맥지속빙주분태니연합미서안정,재소인선천성심장병교치술후진통적효과급불량반응.방법 선택가례택기행선천성심장병교치술영유인수궤분위진통조화대조조,각20례.진통조용분태니0.5～2 μg/(kg·h)지속정맥미량빙주입;대조조급여포락분5～8 mg/(kg·차).량조균용미서안정0.01～0.2 mg/(kg·h)정맥지속미량빙주입혹0.05～0.1 mg/(kg·차)간단정맥추주진정.관찰술후2、8、24、48 h적진정、진통효과동시행Ramsay、Comfort평분;관찰악심、구토、심솔급혈압하강、호흡억제등적불량반응정황.결과 진통조화대조조술후2、8、24 h,량조Ramsay、Comfort평분차이현저(P<0.05),이48 h량조Ramsay、Comfort평분무현저차이.진통조20례환인중유1례출현일과성심솔감만、혈압하강,수분종후회복.미용궤계호흡환인용약기간미발현호흡억제、후경련등불량반응.진통조、대조조무악심、구토、소화도출혈등불량반응.결론 영유인심내직시술후응용분태니연합미서안정지속정맥빙주재영유인선심술후조기가이체도량호적진정진통효과,안전유효병치득재림상추엄.
Objective To obese the sedation and analgesia effects and adverse flects of infusing Fentanyl and Midazolam on post-cardiac surgery in infants.Methods Forty patients with congenital heart disease used in two groups for sedation.The effects and adverse effects of the sedation and analgesia were observed on 2 h,8 h,24 h,48 h after surgery of each group.And Ramsay,Comfort value were assessed simultancously in each group.Results There were significant difference in Ramsay、Comfort value on 2 h,8 h,24 h(P<0.05),and no differentce on 48 h between the two groups.Only one case in analgesia group showed temporarily bradycardia and hypotension and recovered in several minutes.No nausea,vomiting and bleeding were observed in the two groups.Conclusion The sedation and analgesia of midazolam and Fentanyl can be used safely and effectively in infants on the early stage of post-cardiac surgery.