Đánh giá tác dụng an thần gây ngủ trong điều trị bệnh võng mạc trẻ đẻ non bằng laser

DANH GIA TAC DUNG AN THAN GAY NGU

TRONG DIEU TRj BENH VONG MAC TRE DE NON BANG LASER

TOM TAT

Muc tidu: Ddnh gid tdc dung an thin gdy ngu

trong d iiu tri bdnh vdng mac trd 66 non (BVMTDN)

bdng laser. Doi tuxmg: 52 b$nh nhan (BN) vdi 104

mdt cd bdnh, cd chi djnh d iiu tri laser tai khoa so sinh

Bdnh vi$n phy sdn TW tir 6/2009 den 7/2010. Nghidn

ciru thCr nghidm Idm sdng. Ket qud: Morphin sir dung

mdt lin duy n h it d 100% BN, Midazolam phdi dung

lin hai d 17,31% BN. Lidu dung trung binh lin thir

n h it cua hai thudc Id 0,064mg ± 0,013 (0,04mg d in

0,085mg) vd lin thir hai vi/i Midazolam Id 0,119mg ±

0,024. Thdi gian trung binh tir khi dung an gdy ngu

d in khi tiSn hdnh laser Id 20 phut, thdi gian laser mdt

BN trung binh Id 52,78 phut ± 29,84. Thdi gian hdi

tinh trung binh Id 8 gid. 86,54% BN dat k it qud t6t.

Phuxyng phdp ndy c6 th i tiin hdnh laser sdm, khdng

tri hodn, thirc hidn dirge ngay tai khoa so sinh vd cd

khi cd bdnh todn thdn di kdm giup han c h i nhdn lire,

trang thiSt bi, tiit ki$m dirge chi phi d iiu tri. Ty Id biin

chirng nhe vd It gdp, 100% BN khdng phdi gdy md

phdi hop, 23,08% c in thd oxy vd thd mdy. Ket ludn:

Sir dung Morphin k it hop vdi Midazolam c6 th i thay

th i hodn todn gdy md todn thdn trong d iiu tri

BVMTDN bdng laser. K it qud tdt dat dirge d 86,54%

BN. Phuxyng phdp ndy rut ngdn thdi gian d iiu tri, ydu

c iu It v i nhdn lire, trang th iit bi vd chi phi. Ty Id biin

chirng nhe vd it gdp.

TCr khda: An thin gdy ngu.

SUMMARY

To evaluate the effectiveness of preanesthesia

on ROP laser treatment

Objective: To evaluate the effectiveness of

preanesthesia on ROP laser treatment. Patients: 104

eyes of 52 premature infants with prethreshold and

threshold ROP were lasered at neonatal department

of National Hospital of Obstetric and Gynecology from

6/2009 - 7/2010. Morphine and midazolam has been

used for preanesthesia. Clinical tried study. Results:

100% of patients need a single dose of morphine.

17.31% of patients need second doses of midazolam.

The mean of first dose of these two drugs is 0.064mg

± 0.013 (0.04 -0.085mg). The mean of second doses

of midazolam is 0.119mg ± 0.024. The mean time

since starting preanesthesia to beginning laser

treatment was 20 minutes. The mean time for laser

treatment was 52.78 minutes ± 29.84. The means

time for recovering consciousness was 8 hours.

86.54% of eyes get good results. With preanesthesia

technique laser can be done at neonatal department,

NGUYIn VAN HUY, VU THI. BiCH THUY,

TRAN THU HA, PHAM MINH CHAU

BQnh vi$n M it Trung uwng

NGUYEN TH| HA - BQnh viQn Xanh P6n

avoiding transfer patients to others hospital Laser

can be done on time, no need to postpone, even with

infants having systemic diseases Complication is

rare and mild. No infant need converting to general

anesthesia, 23.08% need oxygen supplementing and

mechanic ventilation. Conclusion: Combination of

morphine and midazolam can be replaced for general

anesthesia in laser treatment of ROP Good result

was 86.54%. This method shortens treatment time,

required less human resources, equipment and cost

Complication is rare and mild.

Keywords: Preanesthesia.

DAT VAN 0 £

Bdnh v6ng mac trd dd non Id tinh trang bdnh ly

cua qud trinh phdt triln mach mdu d vdng mgc. Hi$n

nay d nude ta c6 hdng trdm tre de non c in diiu trj

sdm vd c£n c6 phu’O’ng phdp v6 cam da dang d£ c6

th i tiin hdnh phu hop cho mQi tre. Tnrdc ddy dd c6

nhiiu phuang phdp vd cam nhu gdy m6 nOi khi

quan, giam dau an th in gdy ngu, uing thu ic an thin

k it hop gdy t6 tai ch6 hodc gdy t6 dudi bao tenon.

D iiu trj BVMTDN bdng laser d nude ta tu trudc tdi

nay chi dugc tiin hdnh khi gdy md nOi khi quan t?i

cdc trung tdm gdy md h ii sue Idn, ddi hoi nhiiu trang

th ilt bj mdy mdc hd tro\ D i kh lc phuc mdt s i nhucrc

dilm cua phuang phdp ndy, g in ddy dd tiin hdnh sir

dung thuoc an th in gdy ngu thay cho gdy md d l dilu

tri benh vdng mac tr£ de non bdng laser. Ndm 2007

Caitriona K vd cdng su dd sir dung Morphin vd

Midazolam Idm phuang phdp vd cam trong dilu tri

laser cho 109 tre ROP vd k it ludn cd th i thay th i cho

gdy me todn thdn [3], Vi vdy chung tdi tiin hdnh

nghien cuu ndy nhdm myc tidu ddnh gid hi£u qud

phuang phdp an th in gdy ngu trong d iiu trj bdnh

vdng mac de non bdng laser.

DOl TLPONG VA PHUONG PHAP NGHIEN CLTU

1. Ddi tirang nghidn cu>u: 52 tre (104 mdt) cd

BVMTDN duac chi djnh laser tgi khoa sa sinh bdnh

vidn Phu san TW tu thdng 6/2009 d in thdng 07/2010.

Tidu chuln logi tru: cdc trd dang bi bdnh todn thdn

ndng nhu suy hd hip, vidm p hii ndng hodc BVMTDN

hinh thdi hung hdn cue sau.

2. Phuang phdp nghidn cuu:

T h ilt k i nghidn cuu: Nghidn ciru md ta c it ngang,

tiin cuu, theo ddi doc.

Phuang phdp tiin hdnh.

BN duac cdc bdc sT chuydn khoa sa sinh b ln md

bdng thu ic Midazolam (Hypnovel) k it hap vdi

Morphin.

10 Y HOC THI/C HANH (902) - s6 1/2014