地佐辛复合舒芬太尼在婴幼儿先天性心脏病术后静脉镇痛的应用研究

目的探讨地佐辛复合舒芬太尼应用于婴幼儿先天性心脏病术后静脉镇痛的可行性、安全性及镇痛效果。方法选择拟行心脏病手术的婴幼儿80例，随机分为D组及Ds组，每组40例，手术结束后进行术后静脉镇痛治疗。D组：地佐辛0．8mg／kg＋托烷司琼2mg＋生理盐水至120ml；DS组：地佐辛复合舒芬太尼组，地佐辛0．5mg／kg＋舒芬太尼1μg／kg＋托烷司琼2mg＋生理盐水至120ml。术后4h、8h、12h、24h、48h进行镇痛效果评分；监测两组患儿的心率（HR）、收缩压（SDP）、经皮血氧饱和度（SpO2）、呼吸频率（RR）；对不良反应发生情况及临时需追加镇静药物例数进行比较。结果两组患儿镇痛后生命体征无明显差异。镇痛评分：与DS组比较，D组24h内各时段FLACC评分均显著高于DS组，差异有统计学意义（P〈0．05），其余时段比较差异无统计学意义（P〉0．05）。不良反应及需追加镇静药物例数，D组均显著高于DS组，差异有统计学意义（P〈0．05）。结论地佐辛复合舒芬太尼用于婴幼儿先天性心脏病进行术后静脉镇痛治疗，效果满意、副作用低，是一种安全、有效的术后镇痛方法。

Effect of Dezocine combined Sufentanil for postoperative analgesia in children with congenital heart disease

Objective To study the practicable and effect of Dezocine combined Sufentanil for postopera- tive analgesia in children with congenital heart disease. Methods Eighty patients aged less than 3 years old un- dergoing cardiac surgery were randomly and equally divided into 2 groups： Dezocine 0.8 mg/kg and tropisetron 2 mg in D group. Dezocine 0.5 mg/kg and Sufentanil 1 μg/kg and tropisetron 2 mg in SD group. Each drug was di- luted to 120 ml and infused by controlled intravenous pump after operation. The analgesia effect was evaluated and recorded, HR, SDP, SpO2, RR and adverse effects in 24 hours （4 h, 8 h, 12 h, 24 h, 48 h）, along with the case number of requiring additional sedation drug. Results No difference between the two groups of children vital signs in postoperative analgesia. The FLACC values in group D within 48 hours was significantly higher than group SD （P〈0.05）, and the percentages at the rest time points hand no significant difference. The number of cases re- quiring additional sedation drug and adverse effects in group D was more than group SD （P〈0.05）. Conclusion Dezocine combined Snfentanil can be used for postoperative analgesia in children with congenital heart disease with satisfactory effect and less side effects.