舒芬太尼用于小婴儿术后静脉自控镇痛的效果

The Efficacy of Sufentanil for Postoperation Analgesia in Infant

目的:观察舒芬太尼用于小婴儿术后静脉自控镇痛(PCA)的效果。方法:129例择期腹部外科手术患儿,按年龄分为组I(<2岁)与组II(>2岁),各组再随机分为2个亚组,分别应用吗啡(M组)或舒芬太尼(S组)进行术后PCA。随访并记录术后3d的FLACC(Face,Leg,Activity,Cry,Consolability)量表评分、面部表情评分、Ramesay评分、不良反应发生率及患儿与家长对术后镇痛的满意率。结果:FLACC评分与面部表情评分均随时间增长而递减。术后第1天FLACC评分SⅠ组>SⅡ组、MⅠ组>MⅡ组,面部表情评分MⅠ组>MⅡ组、MⅠ组>SⅠ组;幼儿术后Ramesay评分随时间增长而递减,第1天Ramesay评分MⅡ组>MⅠ组。不良反应发生率SⅠ组<SⅡ组、MⅠ组<MⅡ组;所有家长的满意度相仿。结论:与用吗啡相比,小婴儿应用舒芬太尼进行术后PCA,可减少过度镇静的发生。但无论用吗啡或舒芬太尼,小婴儿术后第1天镇痛、镇静效果均比幼儿差,需要更安全和有效的术后镇痛方式。

Objective：To investigate the efficacy of sufentanil for postoperation analgesia in infant.Methods：A total of 129 children undergoing elective abdominal surgery were divided into 〉2 groups according to their ages.Then they were randomly divided into 2 groups： Group SⅠ（age 〉2yr,provided with sufentanil）,Group SⅡ（age〈2yr,provided with sufentanil）,Group MⅠ（age 〈2yr,provided with morphine）,and Group MⅡ（age〉2yr,provided with morphine）.The face,legs,activity,cry,consolability（FLACC）,pain tool face pain score,Ramesay score,the adverse effects,degrees of satisfaction with analgesia were recorded at the first 3 days after the surgery.Results： FLACC and the face pain score decreased with the time.On first day after surgery,the FLACC of Group SⅠ was higher than that of Group SⅡ,and the FLACC of Group MⅠ was higher than that of Group MⅡ.The face pain score of MⅠ was higher than MⅡ,and the face pain score of MⅠ was higher than SⅠ.The Ramesay score decrease with the time.On the first day after surgery,the ramesay score of Group MⅡ was higher than that of Group MⅠ.The incidence of adverse effect in SⅡ and MⅡwas higher than that in SⅠ and MⅠ.The degrees of satisfaction in those 4 groups was similar.Conclusions： Compared with morphine,sufentanil decrease the possibility of excessive sedation.Either morphine or sufentanil used,the infants tend to be more painful and upset.So there ought to be a more efficient way for postoperation analgesia in infant.