儿科重症多发伤行舒芬太尼联合咪达唑仑镇痛镇静治疗价值

The Analgesic and Sedative Value of Sufentanil Combined with Midazolam in Severe Multiple Injuries in Pediatrics

目的分析应用咪达唑仑联合舒芬太尼镇痛镇静重症多发伤患儿对其生命体征、镇痛效果、镇静效果及并发症的影响。方法方便选取86例于2016年7月—2021年6月因多发伤进入该院治疗的重症患儿作为研究对象,根据入院时间先后将患儿分组:将2016年7月—2018年12月入院的43例患儿编为对照组(应用常规镇痛镇静方案);将2019年1月—2021年6月入院的43例患儿编为观察组(应用咪达唑仑联合舒芬太尼镇痛镇静)。比较两组镇痛评分、镇静评分、临床指标(血氧饱和度、呼吸、心率)及并发症发生(恶心、躁动)情况。结果观察组给药1 h、给药6 h、给药12 h镇静评分较对照组高,镇痛评分较对照组低,差异有统计学意义(P<0.05);观察组停药后恶心发生率为2.33%,较对照组的20.93%低,差异有统计学意义(χ^(2)=7.242,P<0.05);观察组呼吸、心率低于对照组,差异有统计学意义(P<0.05);观察组停药后躁动发生率为2.33%,较对照组的23.26%低,差异有统计学意义(χ^(2)=8.444,P<0.05);观察组血氧饱和度高于对照组,差异有统计学意义(P<0.05)。结论应用咪达唑仑联合舒芬太尼镇痛镇静重症多发伤患儿有助于稳定生命体征,安全性较高,具有较好的药物效果,且作用持续时间较长。

Objective To analyze the effects of midazolam combined with sufentanil for analgesia and sedation in children with severe multiple injuries on their vital signs,analgesic effects,sedative effects and complications.Methods 86 cases of severely ill children who entered the hospital for treatment from July 2016 to June 2021 due to multiple injuries were conveniently selected as the research objects,and the children were divided into groups according to the time of admission.The 43 children admitted from July 2016 to December 2018 were included in the control group(using conventional analgesia and sedation regimens).The 43 children admitted from January 2019 to June 2021 were included in the observation group(application of midazolam combined with sufentanil for analgesia and sedation).The analgesia score,sedation score,clinical indicators(blood oxygen saturation,respiration,heart rate)and complications(nausea,restlessness)were compared between the two groups.Results The sedation score of the observation group was higher than that of the control group at 1 h,6 h and 12 h,but the analgesia score was lower than that of the control group,the difference was statistically significant(P<0.05).The incidence of nausea after drug withdrawal was 2.33%in the observation group,lower than 20.93%in the control group,and the difference was statistically significant(χ^(2)=7.242,P<0.05).Respiration and heart rate in observation group were lower than those in control group,and the differences were statistically significant(P<0.05).The incidence of agitation in the observation group after drug withdrawal was 2.33%,lower than that in the control group 23.26%,and the difference was statistically significant(χ^(2)=8.444,P<0.05).Blood oxygen saturation of observation group was higher than control group,the difference was statistically significant(P<0.05).Conclusion The application of midazolam combined with sufentanil for analgesia and sedation in children with severe multiple injuries can help stabilize the vital signs,has high safety,has good drug effects,and has a longer duration of action.