芬太尼在早产儿PICC置管中镇痛效果的研究

The effect of relieving pain during giving peripherally inserted central catheters for the premature using fentanyl

目的探讨芬太尼对早产儿PICC置管的镇痛效果。方法选择行PICC置管的早产极低出生体质量患儿120例,将其随机分为3组:对照组、非营养性吸吮组和芬太尼组,每组各40例。采用早产儿疼痛量表比较各组患儿在PICC置管前15s、穿刺时、送管时、固定时及操作后30s时的疼痛评分,并比较各组患儿PICC置管的穿刺次数。结果在置管前15s,各组患儿的疼痛评分差异无统计学意义(F=0.722,P=0.488);各组患儿在PICC置管穿刺时、送管时、固定时及置管后30s时疼痛评分比较,差异均有统计学意义(P<0.001),且芬太尼组患儿疼痛评分低于非营养性吸吮组(P<0.05);各组患儿PICC置管的穿刺次数比较,差异有统计学意义(F=94.908,P<0.001)。结论非营养吸吮及芬太尼镇痛能缓解早产儿PICC置管过程中的疼痛,而芬太尼镇痛效果更明显,值得在临床中推广。

Objective To investigate the analgesic effect of fentanyl on PICC catheter in premature infants. Methods Totally 120 premature infants with very low birth weight were randomly divided into three groups, a control group, a non nutritious sucking group and a fentanyl group, with 40 cases in each group. The pain scores at 15 s before insertion, puncturing, tube delivery, fixation and 30 s after operation of PICC catheterization were compared in 3 groups. Results At 15 s before insertion, no significant differences were observed in pain score between the three groups （F=0. 722,P=0. 488）. However, there were significant differences in pain scores between the three groups during PICC catheterization, tube delivery, fixation and 30 s after catheterization（P〈0. 001）, and the pain score of fentanyl group was lower than that of non nutritional sucking group. The puncture times of PICC catheterization were significantly different in each group（F=94. 908,P〈0. 001）. Conclusion Non nutritional sucking and fentanyl analgesia can relieve the pain during PICC catheterization in premature infants, and the analgesic effect of fentanyl is more obvious, which is worth popularizing in clinic.