瑞芬太尼联合咪达唑仑在小儿先心术后机械通气中镇痛镇静的效果分析

Analysis of the Application Effect of Remifentanil Combined with Mid⁃azolam on Analgesia and Sedation in Mechanical Ventilation after Con⁃genital Heart Surgery in Children

目的探讨瑞芬太尼联合咪达唑仑在小儿先心术后机械通气中镇痛镇静的效果。方法便利选取2020年4月—2023年12月南通大学附属常州市儿童医院收治的107例小儿先心术患儿为研究对象,根据不同镇痛镇静方法分为两组,观察组(54例)接受瑞芬太尼联合咪达唑仑微泵维持持续镇静镇痛,对照组(53例)接受咪哒唑仑镇静加间断芬太尼镇痛。对比两组镇静效果、疼痛程度、不良反应发生率、生命体征。结果用药后,观察组镇静效果评分为(2.38±0.67)分,较对照组的(1.56±0.31)分高,差异有统计学意义(t=8.099,P<0.05)。用药前和用药时,两组疼痛程度对比,差异无统计学意义(P均>0.05),用药完毕后6 h,观察组疼痛程度较低,差异有统计学意义(P<0.05)。用药完毕后6 h,观察组心率和收缩压低于对照组,差异有统计学意义(P均<0.05)。观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论瑞芬太尼联合咪达唑仑在小儿先心术后机械通气中的镇静效果较好,患儿疼痛程度较低,且不良反应较少。

Objective To investigate the effect of remifentanil combined with midazolam on analgesia and sedation in mechanical ventilation after congenital heart surgery in children.Methods A total of 107 children with congenital heart disease admitted to Changzhou Children's Hospital Affiliated to Nantong University of Jiangsu Province from April 2020 to December 2023 were conveniently selected as the research objects.According to different analgesia and sedation methods,they were divided into two groups.The observation group(54 cases)received remifentanil combined with midazolam micropump to maintain continuous sedation and analgesia,while the control group(53 cases)received midazolam sedation and intermittent fentanyl analgesia.The sedative effect,pain degree,incidence of adverse reac⁃tions and vital signs were compared between the two groups.Results After treatment,the sedation effect score of the observation group was(2.38±0.67)points,which was higher than that of the control group(1.56±0.31)points,and the difference was statistically significant(t=8.099,P<0.05).Before and during medication,there was no significant differ⁃ence in the degree of pain between the two groups(both P>0.05),at 6 hours after medication,the degree of pain in the observation group was lower,and the difference was statistically significant(P<0.05).At 6 hours after medication,the heart rate and systolic blood pressure in the observation group were lower than those in the control group,and the dif⁃ferences were statistically significant(both P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion The sedative ef⁃fect of remifentanil combined with midazolam in mechanical ventilation after congenital heart surgery in children is better,the pain degree of children is lower,and the adverse reactions are less.