芬太尼复合曲马多连续静脉泵注在小儿术后镇痛效果的观察
发布时间：2018-09-12 11:14
【摘要】：目的:观察芬太尼复合曲马多连续静脉泵注在小儿术后镇痛的效果,探讨其用于小儿术后镇痛的安全性及有效性。方法:选择75例全身麻醉下择期行腹部手术、唇腭裂术、颈部肿物切除术的患儿,年龄1~6岁,ASA分级Ⅰ~Ⅱ级,体重8~22 kg,分成3组:芬太尼组(F组,n=25),术后48h予芬太尼0.15μg/(kg·h);芬太尼复合曲马多组(Q组,n=25),术后予芬太尼0.1μg/(kg·h)复合曲马多30μg/(kg·h);传统方法镇痛治疗组:(C组,n=25),根据患儿需要予口服曲马多胶囊1mg/kg。所有患儿均采用统一的麻醉方法。F组及Q组术毕患儿恢复呼吸功能后启用镇痛泵至术后48h。记录术后72h内各时点患儿的平均动脉压MAP、心率HR、脉搏氧饱和度Sp O2、FLACC疼痛评分、Ramsay镇静评分及呼吸抑制、嗜睡、恶心呕吐、皮肤瘙痒等药物不良反应,记录术后72h患儿需口服镇痛药物的时间段和用药情况。结果:(1)3组患儿性别、年龄、身高、体重、切口长度、手术时间、麻醉时间、术后住院天数,差异无统计学意义(P0.05)。(2)各时点HR、MBP、Sp O2的组间比较:T1~T8,F组MBP均明显低于C组,T1、T2、T3、T4、T5、T7各时点Q组MBP均明显低于C组,T6、T7、T8、T9时点F组和Q组HR均低于C组,差异有统计学意义(P0.05㖞。其余各时点差异无统计学意义(P0.05)。组内比较:T9时点F组和Q组MAP比T1均更高,差异有统计学意义(P0.05㖞。其余各时点差异无统计学意义(P0.05)。(3)Ramsay镇静评分的比较:各组各时点患儿Ramsay镇静评分差异无统计学差异(P0.05)。(4)各组FLACC疼痛评分的比较:T2~T8各时点,F组和Q组患儿FLACC疼痛评分均低于C组,差异有统计学意义(P0.05㖞,T1、T9各组FLACC疼痛评分差异无统计学意义(P0.05)。(5)术后镇痛不良反应、术后并发症的比较:差异无统计学差异(P0.05)(6)术后追加镇静、镇痛药物情况的比较:术后72 h内,C组共有23例患儿需使用镇静、镇痛药,F组有4例,Q组有5例,差异有统计学意义(P0.05㖞。结论:(1)术后48h予0.15μg/(kg·h)芬太尼静脉连续泵注或0.1μg/(kg·h)芬太尼复合30μg/(kg·h)曲马多静脉连续泵注均可以为患儿提供完善的术后镇痛,二者效果无明显差异。未见严重不良反应,是安全、有效的小儿术后镇静方式。(2)芬太尼联合曲马多应用于术后镇痛可以减少芬太尼用量。
[Abstract]:Objective: to observe the effect of continuous intravenous infusion of fentanyl combined with tramadol on postoperative analgesia in children, and to explore the safety and efficacy of fentanyl combined with tramadol for postoperative analgesia in children. Methods: 75 children with abdominal operation, cleft lip and palate operation and neck tumor resection under general anesthesia were selected. Their age was 1 ~ 6 years old and ASA grade 鈪，
本文编号：2238832
[Abstract]:Objective: to observe the effect of continuous intravenous infusion of fentanyl combined with tramadol on postoperative analgesia in children, and to explore the safety and efficacy of fentanyl combined with tramadol for postoperative analgesia in children. Methods: 75 children with abdominal operation, cleft lip and palate operation and neck tumor resection under general anesthesia were selected. Their age was 1 ~ 6 years old and ASA grade 鈪，
本文编号：2238832
本文链接：https://www.wllwen.com/yixuelunwen/eklw/2238832.html
最近更新
教材专著
