舒芬太尼和曲马多在婴幼儿心脏手术术后镇痛的应用

Application of sufentanil or tramadol for postoperative analgesia in infants after heart surgery

目的比较舒芬太尼和曲马多用于婴幼儿心脏手术术后镇痛效果。方法 40例1-3岁室间隔缺损手术患儿随机均分为T组(曲马多8mg/kg)和S组(舒芬太尼2μg/kg);两组药物分别加生理盐水稀释至100ml,加入自动镇痛泵中,以2ml/h静脉泵入。记录术后气管导管拔出时间、术后48h内不良反应和术后4h(T1)、12h(T2)、24h(T3)、36h(T4)和48h(T5)时的血流动力学指标及镇痛、镇静评分。结果两组术后气管导管拔出时间和各时间点血流动力学指标差异无统计学意义(P>0.05)。两组均无明显不良反应发生。T组T1-T3时的术后镇痛评分高于S组(P<0.05),T1、T2时的镇静评分低于S组(P<0.05)。结论舒芬太尼和曲马多用于婴幼儿心脏手术术后镇痛均安全有效,舒芬太尼效果优于曲马多。

Objective To compare the effect of sufentanil with tramadol for postoperative analgesia in infants underwent heart surgery. Methods Forty infants with ventricular septal defect aged 1-3 years were equally randomized into two groups of T（analgesia with tramadol 8 mg/kg） and S （analgesia with sufentanil 2μg/kg）. The drugs were diluted to 100 ml by normal saline and pumped in a dose of 2 ml/h for postoperative analgesia. The extubation time and analgesia-related adverse reactions within 48 hours were recorded. Hemodynamic indexes, analgesia score and sedation score were recorded at 4, 12, 24,36,48 hours after operation as well. Results There were no significant differences in extubation time and hemodynamic indexes at above time points between two groups （P〈0. 05）. No obvious analgesia-related adverse reaction was observed in all infants. The analgesia score at 4, 12 and 24 hours after operation was higher and sedation score at 4 and 12 hours after operation was lower in group T than those in group S（P〈0. 05）. Conclusion Sufentanil and tramadol are safe and effective for postoperative analgesia in infants after heart surgery. The effect of sufentanil is better than that of tramadol.