婴幼儿术后用舒芬太尼、芬太尼持续静脉镇痛的观察

目的观察婴幼儿舒芬太尼或芬太尼持续静脉输注术后镇痛的效果及其安全性。方法128例婴幼儿手术，分为A、B、C三组。手术后A组昂丹司琼0．1mg／kg静脉注射，B组舒芬太尼0．008mg·kg^-1·d^-1持续静脉注射，C组术毕先以昂丹司琼0．1mg／kg静脉注射，再以芬太尼0．08mg·kg^-1·d^-1持续静脉注射，上述药物稀释至100ml，4ml／h。术后2、6、12、24h评估镇痛、镇静效果和观察镇痛满意率与不良反应。结果术后初期（2h）各组镇痛效果无统计学差异，其他时点，A组镇痛效果较差，满意率较低；C组恶心、呕吐发生率较高，镇痛满意率与B组相当；B组镇痛效果佳且满意率最高，恶心、呕吐发生率低。结论婴幼儿给予舒芬太尼0．008mg·kg·mg^-1·d^-1术后持续静脉镇痛，效果较好，未见呼吸抑制，无恶心呕吐、嗜睡等不良反应。

Treatment of postsurgical pain with sufentanil or fentanyl by continuous intravenous analgesia In infant

Objective To appraise the effectiveness and safety of sufentanil or fentanyl in treatment of postsurgical pain by continuous intravenous analgesia in infant. Methods 128 infantile patiens,were randomly divided into 3 groups： in group A, intravenous ondensetron 0. 1 mg/kg was accepted;in group B continuous intravenous analgesia with sufentanil 0. 008mg · kg^- 1 · d^-1 and in group C continuous intravenous analgesia with fentanyl 0.08 mg · kg^- 1 · d^-1 were accepted respectively . CHOPS, UMSS satisfactory rate of analgesia after recovery were recorded. Ondansetron were used when the infantile patiens vomited and PONV were recorded. Effect of drug On the respiratory and circulatory systems were also assessed. Results Compareing A with B and C group,the CHOPS were increased significantly during 6-24 h after operation, （P〈0.05）; the UMSS were decreased significantly during 6-24 h, （P〈0.05）; compareing C with A and B group, the PONV were increased significantly after operation, （P〈0.05） ; the respiratory and circulatory systems were steady all the time. Conclusion Continuous intravenous analgesia with sufentail 0. 008 mg · kg^- 1 · d^-1 is a safe and efficient method in postsurgical analgesia in infantile patiens.