【摘要】 目的观察丙泊酚复合芬太尼用于小儿心脏手术后机械通气时的镇静作用及对血流动力学的影响。方法先天性心脏病手术患儿40例随机分为丙泊酚(PP)组和丙泊酚复合芬太尼(PF)组,每组20例,PP组全程静脉输注丙泊酚镇静;PF组静脉输注丙泊酚和用芬太尼(0.2μg·kg-1·min-1)镇静。根据Ramsay氏分级标准调整丙泊酚用量,达到并维持理想镇静深度。记录用药量、镇静时间、停药后苏醒时间、停药至拔管时间,停药后再入睡发生情况和镇静效率;观察达到理想镇静深度时、脱机及拔管前后的心率、血压和脉搏血氧饱和度变化。结果两组间心率、血压和脉搏血氧饱和度无统计学差异(P>0.05)。镇静时间、停药后再入睡及恶心发生情况与组间比较均无显著差异(P>0.05)。与PP组比较,PF组丙泊酚用药量、停药后苏醒时间及停药至拔管时间显著减少(P<0.05)。结论丙泊酚复合芬太尼静脉输注法可以达到小儿心脏手术后行机械通气治疗时所需的镇静要求,且效果优于单纯使用丙泊酚。更多还原

【Abstract】 Objective To study safety and efficacy of propofol combined with fentanyl when used for sedation of children who required mechanical ventilation after cardiac surgery. Methods Forty children with congenital heart disease who underwent cardiac surgery were randomly divided into propofol( PP) group and propofol combined with fentanyl( PF) group. All the children required intubation and mechanical ventilation in ICU. The children in PP group were only injected with propofol for sedation. Those in PF group were done with propofol and fentanyl( 0. 2μg·kg-1·min-1). Total sedation time,percentage of satisfied sedation in total sedation time,times related with sedation,propofol consumption and hemodynamic parameters were recorded. Results Total sedation time,percentage of satisfied sedation in total sedation time,heart rate,mean arterial blood pressure and saturation of blood oxygen were not statistically different between two groups( all P > 0. 05). Compared with PP group,time from stopping administration of drug to coming round completely,time pulling out bronchial catheter,lethargy rate after pulling out catheter and propofol consumption in PF group were statistically reduced( all P< 0. 05). Conclusion Propofol combined with fentanyl is safe and efficacious for sedation of children who required mechanical ventilation after cardiac surgery. The quality of sedation was better in the PF group.更多还原