舒芬太尼联合咪达唑仑镇痛镇静在小儿机械通气中的应用

Application of Sufentanil Combined with Midazolam Analgesia in Pediatric Mechanical Ventilation

摘要: 目的：观察舒芬太尼联合咪达唑仑作用于小儿机械通气患儿镇痛镇静的效果以及安全性。方法：选取124例机械通气的患儿，随机分成观察组61例，对照组63例，观察组遵医嘱镇静诱导后应用咪达唑仑联合舒芬太尼静脉内持续泵入，剂量：舒芬太尼0.2~0.5 μg/(kg∙h)⁻¹；咪达唑仑2~5 μg/(kg∙min)⁻¹；对照组遵医嘱应用咪达唑仑2~5 μg/(kg∙min)⁻¹静脉内持续泵入。利用Ramsay镇静评分表以及FLACC疼痛评分表，观察记录镇静镇痛后不同时间段的分值以及理想镇静的差异，同时观察两组患儿应用药物后的不良反应。结果：观察组用药后6小时、24小时其镇静效果优于对照组；观察组在非计划拔管率、吸痰时的不良反应以及停药后谵妄的表现方面明显低于对照组。结论：舒芬太尼联合咪达唑仑组其镇静镇痛效果优于咪达唑仑组，且非计划拔管，停药后发生的不良反应明显降低。

Abstract: OBJECTIVE: To observe the effect and safety of sufentanil combined with midazolam on analgesia and sedation in children with mechanical ventilation. METHODS: A total of 124 children with me-chanical ventilation were randomly divided into observation group (n = 61) and control group (n = 63). The observation group was intravenously administered with midazolam combined with sufentanil after sedation and induction. Dosage: ShufenTaini 0.2~0.5 μg/(kg∙h)⁻¹; midazolam 2~5 μg/(kg∙min)⁻¹; control group according to doctor’s advice with midazolam 2~5 μg/(kg∙min)⁻¹ In-travenous pumping. The Ramsay sedation score and the FLACC pain score table were used to ob-serve the scores of different time periods after sedation and analgesia, as well as the differences in ideal sedation. The adverse reactions after drug application were observed. RESULTS: The sedative effect of the observation group was better than that of the control group at 6 hours and 24 hours after treatment. The untreated epidural rate, adverse reactions during sputum withdrawal and the performance of sputum after withdrawal were significantly lower in the observation group than in the control group. CONCLUSION: The sedative analgesic effect of sufentanil combined with midazolam is better than that of midazolam, and the adverse reactions such as unplanned detubation and withdrawal are significantly reduced.