Objective  To observe the analgesic and sedative effects of dexmedetomidine combined with fentanyl on neonatal mechanical ventilation.

Methods  96 newborns 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) after 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 in turn, while the Ramsay scores of the two groups increased in turn  (P<0.05); and the NIPS scores of the study group were lower than those of the control group, the Ramsay scores of the study group were significantly higher than those of the control group (P<0.05). The total incidence of adverse reactions in the study group was significantly lower than in the control group (P<0.05).

Conclusion  Dexmedetomidine combined with fentanyl has significant analgesic and sedative effect on neonatal mechanical ventilation, and has little effect on hemodynamics and high safety.

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