不同剂量舒芬太尼静脉持续输注用于小儿骨科手术后镇痛的效应

Effect of Different Doses of Sufentanil Intravenous Infusion in Pediatric

目的观察不同剂量舒芬太尼静脉持续输注用于骨折手术后镇痛的临床效应，并探讨其安全性。方法择期骨科手术患儿60例，麻醉ASA分为Ⅰ级或Ⅱ级，随机分为3个组，每组20例患儿。手术完毕连接舒芬太尼镇痛泵：1组负荷剂量0．03μg/kg，维持剂量0．03μg/（kg·h）；2组负荷剂量0．04μg／kg，维持剂量0．04μg／（kg·h）；3组负荷剂量0．05μg/kg，维持剂量0．05μg/（kg·h）。观察术后2、4、8、12、24、48h各时点的心率（HR）、血氧饱和度（SpO2）、呼吸（RR）、镇痛评分、镇静评分及不良反应的发生情况。结果镇痛效果评分：1组各时点明显优于2组和3组，差异有统计学意义（P〈0．05）；镇静效果评分：3组各时点优于1组和2组，差异有统计学意义（P〈0．05）；3个组SpO2比较，差异无统计学意义（P〉0．05）；不良反应：3组有2例术后出现嗜睡，2例出现恶心呕吐，与1组和2组比较，差异有统计学意义（P〈0．05）。结论舒芬太尼0．04μg／（kg·h）用于骨科手术后静脉镇痛更安全有效。

Objective To observe different doses of sufentanil intravenous continuous infusion for analgesia after operation of fi＇acture clinical effect, and discuss its security. Methods 60 cases of children with orthopedics operation were selected with anesthesia ASA Ⅰ or Ⅱ , and were randomly divided into 3 groups, each group with 20 cases. Sufentanil analgesia pump was connected after operation ： Ⅰ groups of a loading dose of 0.03 μg/kg, with the mainte- nance dose of 0.03 μg/（ kg · h ） , Ⅱ groups of 0.04 μ g/kg, with the maintenance dose of 0.04 μg/（ kg · h ）, Ⅲ groups of a loading dose of 0.05 μg/kg,with the maintenance dose of 0.05μg/（ kg · h）. We observed the heart rate （ HR）, Oxygen saturation （ SpO2 ）, Breathing （RR） , Analgesia, sedation score and the score of the occurrence of ad- verse drug reactions of postoperative 2,4,8,12,24,48 h each time. Results Analgesic effect of scores：The Ⅰ group with different time points were significantly higher than in the Ⅱ group and the Ⅲ group,the differences were statisti- cally significant （P 〈 0.05 ）. Effect of sedation scores：The Ⅲ group with different time points were higher than that of group Ⅰ and group Ⅱ , the differences were statistically significant（ P 〈 0.05 ）, SpO2 of the 3 groups were not statisti- cally significant（ P 〉 0.05 ）. Adverse reaction ： m gronps of 2 patients with postoperative drowsiness, and compared with the 1 group and the 2 group, the differences were statistically significant （ P 〈 0.05 ）. Conclusion Sufentanil 0.04 μg/（ kg · h） used in department of orthopedics intravenous analgesia after operation are safer and more effec- tive.