右美托咪定复合芬太尼对新生儿机械通气的镇痛镇静效果观察  

Analgesic and sedative effects of dexmedetomidine combined with fentanyl on neonatal mechanical ventilation

作　　者：郭华 王婷婷 耿宝 回立远 张香茹 范雪爱 Hua GUO;Ting-Ting WANG;Bao GENG;Li-Yuan HUI;Xiang-Ru ZHANG;Xue-Ai FAN(Department of Neonatology,The Third Hospital of Xingtai City,Xingtai 054000,Hebei Province,China)

机构地区：[1]邢台市第三医院新生儿科,河北邢台054000

出　　处：《药物流行病学杂志》2023年第3期256-262,共7页Chinese Journal of Pharmacoepidemiology

基　　金：邢台市重点研发计划项目(2020ZC265)。

摘　　要：目的观察右美托咪定复合芬太尼对新生儿机械通气的镇痛镇静效果。方法接受机械通气的新生儿96例随机分为对照组和研究组,每组48例。对照组在机械通气过程中静脉持续泵入芬太尼,研究组在机械通气过程中静脉持续泵入右美托咪定复合芬太尼。比较两组患儿的机械通气时间,记录两组患儿用药前(T0)、用药后1 h(T1)、用药后12 h(T2)、用药后24 h(T3)、用药后48 h(T4)的心率(HR)、平均动脉压(MAP)以及呼吸频率(RR)、吸气峰压(PIP)变化;采用新生儿疼痛量表(NIPS评分)以及Ramsay评分对两组患儿上述时间点的镇痛镇静效果进行评价,并对比两组不良反应。结果两组患儿机械通气时间比较差异无统计学意义(P>0.05)。T1~T4时,两组HR较T0时降低(P<0.05),但研究组上述时间点HR高于对照组(P<0.05);研究组的MAP在T0~T4时无明显变化(P>0.05),而对照组T1~T3时的MAP较T0时降低(P<0.05),T1时研究组MAP高于对照组(P<0.05);T1~T3时,对照组RR较T0时降低(P<0.05),研究组RR仅在T3时低于T0时(P<0.05),且研究组RR在T1时高于对照组(P<0.05);两组PIP在T3、T4时较T0时降低(P<0.05),且T2~T4时研究组PIP低于对照组(P<0.05)。T1~T4时,两组患儿的NIPS评分依次降低,Ramsay评分则依次升高(P<0.05),且研究组患儿的NIPS评分均低于对照组(P<0.05),Ramsay评分高于对照组(P<0.05)。研究组总不良反应发生率明显低于对照组(P<0.05)。结论右美托咪定复合芬太尼对新生儿机械通气有显著镇痛镇静效果,对血流动力学水平影响小,安全性高。Objective To observe the analgesic and sedative effects of dexmedetomidine combined with fentanyl on neonatal mechanical ventilation.Methods 96newborns who received mechanical ventilation in our hospital from March 2020 to March 2022 were selected as the research objects.They were randomly divided into control group and study group,with 48 cases in each group,the control group was continuously pumped with fentanyl during mechanical ventilation,and the study group was continuously pumped with dexmedetomidine combined with fentanyl during mechanical ventilation.The mechanical ventilation time of the two groups was compared.The heart rate(HR),mean arterial pressure(MAP),respiratory rate(RR)and peak inspiratory pressure(PIP)of the two groups before medication(T0),1 h(T1),4 h(T2),12 h(T3)and 24 h(T4)a?ter medication were recorded.Neonatal pain scale(NIPS score)and Ramsay score were used to evaluate the analgesic and sedative effects of the two groups at each time point,and the adverse reactions of the two groups were compared.Results There was no significant difference in the mechanical ventilation time between the two groups(P>0.05).At T1-T4,the HR of the two groups was lower than that of the group at T0(P<0.05),but the HR of the study group at the above time points was higher than that of the control group(P<0.05).There was no significant difference in MAP between the study group at T0-T4(P>0.05).The MAP of the control group at T1-T3 was lower than that of the control group at T0(P<0.05),and the MAP of the study group at T1 was higher than that of the control group(P<0.05).The RR of the control group at T1 and T3 was lower than that at T0(P<0.05),while the RR of the study group at T3 was lower than that at T0(P<0.05),and the RR of the study group at T1 was higher than that of the control group(P<0.05).The PIP of the two groups at T3 and T4 were lower than those at T0(P<0.05),and the PIP of the study group was lower than that of the control group at T2-T4(P<0.05).At T1-T4,the NIPS scores of the two groups decreased i

关 键 词：右美托咪定 芬太尼 新生儿 机械通气 镇痛 镇静 

分 类 号：R726.1[医药卫生—儿科]