舒芬太尼静脉镇痛对婴儿腹部手术后血气分析的影响

Effect of Sufentanil Intravenous Analgesia on Blood Gas Analysis of Infants After Abdominal Operation

【目的】探讨婴儿腹部手术后应用舒芬太尼镇痛对血气分析的影响。【方法】选择本院近两年腹部手术围术期送入外科重症监护室（SICU）治疗的患婴120例，随机分为观察组（S组）和对照组（C组），其中S组64例，C组56例。所有患儿均未罹患先心病和肺部感染。S组患儿采用镇痛泵方式静脉输注舒芬太尼，参数设置为背景剂量0．04μg／（kg·h），自控剂量0.01μg／kg，锁定时间15min；C组患儿采用静脉点滴曲马多2mg／kg。记录两组患儿术后4h（T1）、8h（T2）、16h（T3）、48h（T4）的疼痛评分、生命体征、血气分析指标及镇痛的不良反应。【结果】两组患儿在四个时间点的收缩压（SBP）、舒张压（DBP）、心率（HR）、呼吸频率（RR）、脉搏氧饱和度（SpO2）等生命体征和血气分析指标动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO。）、氧合指数（PaO2／FiO2）、碱剩余（BE）、血pH值比较差异均无显著性（P〉0．05）。S组患儿的疼痛评分明显低于C组。两组患儿镇痛期间呼吸抑制的发生率比较差异均无显著性（P〉0．05）。S组患儿呕吐的发生率低于C组（P〈0．05）。【结论】婴儿腹部手术后静脉连续输注舒芬太尼未对其血气分析产生不良影响，且镇痛效果更为完善。

[Objective]To observe the effect of sufentanil intravenous analgesia on postoperative blood gas analysis of infants with abdominal surgery. [Methods]During the past two years, 120 patients sent to SICU in perioperative period of abdominal operations were randomly divided into the treatment group （group S） and the control group （group C）, 64 patients in group S and 56 cases in group C. All the children had not suffered from congenital heart disease and pulmonary infection. Children in group S were treated by analgesia pump intravenous infusion of sufentanil ,and the parameter setting for background dose at 0.04 vg/（kg ·h）,the selfcontrolled dose at 0.01μg/k, and the locking time for 15min; Patients in group C were treated with intravenous tramadol 2 mg/kg. The pain score, vital signs, blood gas analysis index and analgesia adverse reactions of 4h （T1）, 8h （T2）, 16h （Ta）, 48h （W4） were recorded in the two groups.[Results] Children in the two groups at four time points （DBP, SBP, HR, SpO2, RR） and blood gas analysis （PaCO2, PaO2/FiO2, PaO2, BE, blood pH values） were not significantly different （ P 〉 0.05）. The pain score of group S was significantly lower than that of group C. There were no significant differences in the incidence of respiratory depression between the two groups （ P 〉0.05）. The incidence of vomiting in group S was lower than that in group C （ P 0.05）.[Conclusion]Contitinous intravenous infusion of sufentanil injection after infants abdominal Surgery will not produce adverse effects on blood gas and the analgesic effect is found to be perfect.