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目的 比较异丙酚与吗啡、羟丁酸钠用于小儿心脏手术后机械通气时的镇静作用及对血流动力学的影响。方法 10 0例先天性心脏病手术患儿随机分为异丙酚 (PP)组和吗啡、羟丁酸钠 (MR)组 ,每组 5 0例。PP组全程静脉输注异丙酚 10～ 5 0 μg·kg- 1 ·min- 1 镇静 ,MR组用吗啡 0 .1～ 0 .2mg kg、羟丁酸钠 12 0mg kg镇静 ,观察镇静期间的镇静深度、相关时间及血流动力学变化。结果 PP组镇静评分、停药至脱机及拔管时间、拔管后嗜睡率明显低于MR组 (P <0 .0 5 ) ,但满意镇静时间长于MR组 (P <0 .0 5 ) ;PP组循环较MR组稳定 ,心率、血压均低于MR组 (P <0 .0 5 )。结论 异丙酚静脉输注法用于小儿心脏手术后机械通气时的镇静 ,效果优于吗啡、羟丁酸钠 ,值得在ICU推广应用
Objective To compare the sedation and hemodynamics of propofol with morphine and sodium oxybate during mechanical ventilation after pediatric cardiac surgery. Methods One hundred and ten cases of congenital heart disease were randomly divided into propofol (PP) group and morphine and sodium oxybate (MR) group, 50 cases in each group. PP group intravenous propofol 10 ~ 50μg · kg-1 · min-1 sedation, MR group with morphine 0. 1 ~ 0. 2mg kg, 120mg kg of sodium oxybate sedation, observed during sedation Depth of sedation, related time and hemodynamic changes. Results The sedation scores of PP group, withdrawal time to off-line and extubation time were significantly lower than those in MR group after extubation (P <0.05), but the sedation time was longer in PP group than in MR group (P <0.05) ; The PP group was more stable than the MR group, with lower heart rate and blood pressure than the MR group (P <0.05). Conclusion The propofol infusion is more effective than morphine and sodium oxybate in the mechanical ventilation after pediatric cardiac surgery, which is worthy of promotion in the ICU