静脉滴注芬太尼对机械通气新生儿镇痛的效果评估

Assessment of sedative effects by intravenous injection of fentanyl on neonates with mechanical ventilation

目的探讨机械通气新生儿使用芬太尼缓解疼痛过程中的评估。方法将机械通气治疗的新生儿142例随机分为观察组92例和对照组50例，观察组给予静脉滴注芬太尼镇痛治疗，对照组未用镇痛药机械通气治疗。使用N—PASS评估量表，分别于机械通气前和机械通气后1，2h及以后每4h进行疼痛和镇静状态评分。结果观察组患儿用药2h后各时间点的N—PASS疼痛评分低于对照组，特别是在24h后明显下降；使用芬太尼的患儿需要的平均气道压和氧浓度较对照组低，血氧饱和度没有差别。结论静脉滴注芬太尼适用于机械通气新生儿的镇痛治疗，N—PASS能有效评估疼痛和镇静状态，有效地保证用药安全。

Objective We aimed to assess the sedative effects by intravenous injection of fentanyl on neonates with mechanical ventilation. Methods We divided 142 neonates with mechanical ventilation into the observation group （92 eases） and the control group （50 eases）.The observation group received intravenous injection of fentanyl,while the control group was given no sedative medication.The pain and sedation was assessed before ventilation,1 and 2 hours after ventilation and later every 4 hours by adoption of N- PASS evaluation inventory. Results The scores of pain at different time points 2 hours after medication in the observation group were lower than those in the control group,especially 24 hours after medication. The mean airway pressure and oxygen concentration required by the observation group was lower than those of the control group.But no difference was seen in blood oxygen saturation between the two groups. Conclusions Intravenous injection of fentanyl was proper in the application of sedative treatment for neonates with mechanical ventilation.N-PASS inventory could effectively assess the pain and sedation condition and ensure the safe medication.