摘要
目的比较咪达唑仑不同给药方式与右美托咪定在儿童术后镇静及镇痛的有效性,为临床合理用药提供参考。方法选择2015年11月至2016年12在接受腹腔镜下腹股沟斜疝高位结扎手术,需术后常规接受镇静治疗的1~3岁患儿120例,按照随机数字表法分为4组:咪达唑仑肌肉注射组(0.2 mg/kg),咪达唑仑直肠给药组(0.2 mg/kg),咪达唑仑静脉给药组(0.05 mg/kg),盐酸右美托咪定静脉给药组(1.0μg/kg)各30例。比较各组给药后15分钟、30分钟、60分钟、2小时、6小时的镇静和镇痛深度。结果用药后15分钟、30分钟、60分钟、2小时,各组CHEOPS疼痛评分值比较,差异无统计学意义(P>0.05)。用药后第6小时,咪达唑仑静脉给药组镇静效果优于其他组,差异有统计学意义(P=0.046)。用药后各时点,各组间Brussel镇静评分值比较,差异无统计学意义(P>0.05)。结论对术后需要镇静和镇痛的儿童,咪达唑仑和右美托咪定均是有效、安全的药物。如果需要短时间镇静镇痛,建议咪达唑仑直肠给药,尽量不采取静脉用药途径。如果需要长时间维持用药,建议使用右美托咪定持续静脉用药。
Objective To compare the analgesic effects of intramuscular reJection, rectal mhltrahon and intravenous administration of midazolam as well as intravenous administration of dexmedetomidine for postoperative pain relief and sedation in children in order to provide a reference for clinical rational drug use. Methods During the period from November 2015 to December 2016,120 children aged from 1 to 3 years and received the treatment of laparoscopic inguinal hernia high ligation that needed routine postoperative sedation therapy were involved in the study. The patients were randomly divided into 4 groups ,30 in each group. The group 1 received intramuscular injection of midazolam （0.2 mg/kg） ,the group 2 received rectal infiltration of midazolam （0.2 mg/kg） ,the group 3 re- ceived intravenous administration of midazolam （0. 05 mg/kg） , and the control group received intravenous administration of dexmedeto- midine （1.0 txg/kg）. CHEOPS and Brussel were recorded at 1,15,30 and 60 min as well as 2 and 6 hours, postoperatively. The pa- tients were interviewed on the day after the surgery to assess the postoperative pain and sedation. Results There was no significant difference in CHEOPS among the groups after 15,30 and 30 rain and 2 hours after administration of the drugs （P 〉 0：05 ）. However, the analgesic efficacy of intravenous administration of midazolam was found to be better at 6 hours than other 3 groups （ P = 0. 046 ）. No significant differences were observed among the groups with respect to the Brussel （ P 〉 0.05 ）. Conclusion For children needing postoperative sedation and analgesia therapy, midazolam and dexmedetomidine are all safe and effective. If needs a short period of seda- tion and analgesia, rectal infiltration of midazolam should be considered and intravenous administration should not be taken as far as possible. If needs take a long time to maintain medication, the use of continuous intravenous administration of dexmedetomidine is rec- ommended.
出处
《实用医院临床杂志》
2017年第5期56-59,共4页
Practical Journal of Clinical Medicine
基金
四川省卫生和计划生育委员会基金资助(编号:16PJ126)
关键词
咪达唑仑
右美托咪定
镇静
镇痛
Midazolam
Dexmedetomidine
Pain relief
Sedation
