小剂量芬太尼在PICU中的应用

Application of low dosage fentanyl in the pediatric intensive care unit

目的 探索芬太尼的镇静、镇痛作用在PICU中的临床应用。 方法 选择 36例危重患儿用芬太尼 1～ 4μg/(kg·h)持续静脉滴注 ,观察用药后 4h、8h、2 4h、48h的镇静、镇痛效果和对危重儿动脉血气分析、经皮氧饱和度、Ramsay的镇静分级影响 ,以及恶心、呕吐、心律失常的副反应情况。 结果 36例危重患儿在持续静脉滴注芬太尼后发生呼吸机对抗情况减轻 ,氧合和通气功能有所改善 ,用药前、后动脉血气分析变化有显著差异性 (P <0 0 5 ) ,镇静达到 2～ 4级 ,有效率达到 94 4%。 结论 芬太尼的镇静、镇痛作用可减轻危重患儿应激反应 ,减少氧耗等 ,安全有效实施各种操作、治疗 ,而且该药不良反应较小 ,有利于提高危重患儿急救的存活率。

Objective To investigate the sedation and analgesia effects of Fentanyl in the pediatric intensive care unit(PICU).Methods 1～4 μg/(kg·h) Fentanyl continuous intravenous infusion was used in thirty six patients.4 h,8 h,24 h,48 h After treatment the sedation and analgesia,adverse effects,changing of arterial blood gas analysis and the degree of oxygen saturation and Ramsay grade sedation were observed.Results Fentanyl is useful to lighten ventilation confrontation,improve oxygenation and mechanical ventilation,remarkably change the arterial blood gas analysis.The sedation can attain two to four grades.The therapeutic effective rate is 94 4 percent.Conclusion The sedation and analgesia of Fentanyl in the PICU can reduce stress reaction and oxygen consumption,help to prevent atmospheric pressure injury and raise more effective ventilation,secure to safely carry out many operations and therapies.It is advantageous to raise the survival rate of critical patients in the PICU.