新生儿机械通气中应用芬太尼镇静效果观察

目的探讨芬太尼与咪达唑仑在机械通气中的镇静效果。方法选择40例施行机械通气的新生儿进行随机分组，芬太尼组20例，咪达唑仑组20例。芬太尼组：2-5μg·kg^-1·h^-1持续静脉注射。咪达唑仑组：先负荷量0．1mg／kg静脉注射，继以0．05mg·kg^-1·h^-1持续静脉滴注维持，观察两组镇静效果、机械通气时间及用药期间监测心率（HR／）、呼吸（R）、无创平均动脉压（MBP）。结果芬太尼组用药后30min，6、12h和24h的HR、R和MBP与用药前差异均无统计学意义（均P〉0．05）。咪达唑仑组用药后30min，6、12h和24h的HR，R和MBP低于于用药前，差异均具有统计学意义（均P〈0．05）。芬太尼组较咪达唑仑组机械通气时间缩短，日平均气道压降低（均P〈0．05）。两组达理想镇静例数差异无统计学意义（P〉0．05）。结论在新生儿机械通气中使用芬太尼镇静优于咪达唑仑，对循环、呼吸影响少，撤机时间快。

Sedation effect of fentanyl in neonatal mechanical ventilation

Objective To explore sedation effects of fentanyl and midazolam during mechanical ventilation.Methods 40 neonates admitted for purposes of mechanical ventilation were divided into two groups randomly ,20 cases of fentanyl, midazolam group of 20 patients. Group of fentany 2 ～5 μg · kg-1 · h-1 , continuously intravenous injection. Load of midazolam was 0. 1mg/kg by injection,continue to maintain by 0.05mg · kg-1 · h-1. Sedative effects were observed duration of mechanical ventilation and heart rate monitoring during the treatment the in two groups(HR),respiration(R) ,non-invasive mean arterial blood pressure(MBP). Results HR、R and MBP of Fentanyl group had no significant difference between after treatment 30min ,6h, 12h and 24h and before treatment (all P ＞ 0.05). HR、 R and MBP of midazolam group had significant difference between after treatment 30min, 6h, 12h and 24h and before treatment(all P ＜ 0. 05). Fentanyl group took shorter time and lower pressure duration of mechanical ventilation(all P ＜ 0.05). Two of the ideal number of cases sedation was no significant difference(P ＞ 0.05). Conclusion The sedation effect of fentanyl in the neonatal mechanical ventilation was better than midazolam, and impact on circulation and respiration was small, and the time from the ventilator was shorter.