持续静脉注射咪达唑仑联合静脉注射芬太尼在机械通气患儿的应用  

The Sedative Effects of Midazolam Combined with Fentanyl on Children with Mechanical Ventilation

作　　者：马燕[1] 刘纯义[1] 

机构地区：[1]广东省深圳市宝安区妇幼保健院,广东深圳518133

出　　处：《儿科药学杂志》2013年第8期15-17,共3页Journal of Pediatric Pharmacy

摘　　要：目的:观察持续静脉注射咪达唑仑联合静脉注射芬太尼在儿科重症监护病房(PICU)机械通气患儿中镇静、镇痛的临床效果。方法:将我院PICU行机械通气的患儿40例,随机分为持续静脉注射咪达唑仑组(M组)20例和持续静脉注射咪达唑仑联合静脉注射芬太尼组(M+F组)20例,维持镇静深度Ramsay评分3～4级,观察相关指标。结果:两组患儿镇静效果比较差异无统计学意义(P>0.05),镇静48 h时咪达唑仑药物总量M+F组为(85.3±7.8)μg/kg,低于M组的(115.8±9.6)μg/kg,两组比较差异有统计学意义(P<0.05)。两组患儿停药后完全清醒(Ramsay 2级以上)的时间均在60 min左右,两组比较差异无统计学意义(P>0.05)。患儿机械通气时间M+F组为(91±15)min,短于M组的(120±19)min,而且心率、呼吸及氧合指数改善较M组更明显,两组比较差异有统计学意义(P<0.05)。结论:持续静脉注射咪达唑仑联合静脉注射芬太尼能发挥很好的镇静、镇痛效果。Objective： To observe the sedative and analgesia effect of midazolam and fentanyl on children who was on mechanical ventilation in PICU. Methods： Forty children undergoing mechanical ventilation were assigned into two groups randomly. The midazolam group （M group, n = 20） received midazolam continuously by microinfusion pump. The midazolam and fentanyl group （M＋F group, n = 20 ） were given fentanyl injection intravenously and intermittently in addition with midazolam. Both groups maintained Ramsay 3 - 4 level. Results： The sedation efficiency between M group and M＋F group was not significant （ P〉0.05 ）. The amount of midazolam used at 48 hour in M＋F group （85.3±7.8） μg/kg was significantly lower than that in M group（115.8±9.6） μg/kg. The time for recovery of consciousness between the two groups was not significant （P〉0.05）. The time to extubation in M＋F group （91±15） min was shorter than that in M group （120±19） min （P〈0. 05）. In M＋F group, the heart rate, respiration rate and oxygenation index were significantly improved compared with M group. Conclusions： It can provide satisfactory sedation by using continuous midazolam injection intravenously and intermittent fentanyl during mechanical ventilation in PICU.

关 键 词：机械通气 咪达唑仑 芬太尼 

分 类 号：R971.2[医药卫生—药品]