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目的探讨持续静脉泵入舒芬太尼在小儿术后镇痛中的应用。方法将45例行下腹部手术的患儿术后按照舒芬太尼不同剂量随机分为3组,采用静脉持续泵入进行术后镇痛,舒芬太尼Ⅰ组剂量为0.03μg·kg-1·h-1、舒芬太尼Ⅱ组0.04μg·kg-1·h-1、舒芬太尼Ⅲ组0.05μg·kg-1·h-1,各组均加注昂丹司琼4mg。3组均于术后4h、8h、12h、24h、48h对镇痛及镇静效果进行观察,同时记录不良反应的发生情况。结果 3个剂量组在各时点的平均镇痛效果差异有统计学意义(F组别=47.02,P﹤0.01),随时间变化的镇痛效果差异也有统计学意义(F组别×时间=16.91,P﹤0.05),舒芬太尼Ⅰ组的疼痛得分高于其余两组;3组患儿在各时点上平均的镇静效果(F组别=16.76,P﹤0.05)及随时间变化的镇静效果差异有统计学意义(F组别=11.54,P﹤0.05),舒芬太尼Ⅲ组的镇静评分高于其余两组。舒芬太尼Ⅲ组出现较多例数的恶心及呕吐,但经统计学分析3组的不良反应率差异无统计学意义(P﹥0.05)。结论静脉持续泵入舒芬太尼0.04μg·kg-1·h-1镇痛对小儿是有效、安全可行的方法,可取得良好的镇痛效果和较低的不良反应率。
Objective To investigate the application of continuous intravenous sufentanil in postoperative analgesia in children. Methods 45 children undergoing abdominal surgery were randomly divided into three groups according to different doses of sufentanil and continuous intravenous pump for postoperative analgesia. The dose of sufentanil group Ⅰ was 0.03 μg · kg- 1 · h-1, sufentanil group 0.04μg · kg-1 · h-1, sufentanil group Ⅲ 0.05μg · kg-1 · h-1, each group were given ondansetron 4mg . The analgesic and sedative effects were observed at 4h, 8h, 12h, 24h, 48h after operation in all three groups, and the incidence of adverse reactions was also recorded. Results The average analgesic effect of three dose groups at each time point was statistically significant (F group = 47.02, P <0.01), and the difference of analgesic effect with time was also statistically significant (F group × time = 16.91, P <0.05). The pain scores of sufentanil group Ⅰ were higher than those of the other two groups. The mean sedation level of sufentanil group Ⅰ (F = 16.76, P <0.05) (F group = 11.54, P <0.05). The sedation score of sufentanil group Ⅲ was higher than the other two groups. There were more cases of nausea and vomiting in sufentanil group Ⅲ, but no statistically significant differences were found in the adverse reaction rate among the three groups (P> 0.05). Conclusion Continuous intravenous injection of sufentanil 0.04μg · kg-1 · h-1 analgesia is an effective, safe and feasible method for pediatric patients with good analgesic effect and low adverse reaction rate.