不同浓度舒芬太尼用于术后静脉自控镇痛的比较

Comparative effects of sulfentanil with different concentrations in PCIA

目的观察不同浓度的舒芬太尼应用于脊柱手术病人术后静脉自控镇痛(PC IA)的疗效,探讨舒芬太尼PC IA的安全有效浓度。方法选择择期脊柱手术病人90例,随机分为3组,每组30例。S1组:1.0μg/m l舒芬太尼+80μg/m l恩丹西酮;S2组:1.2μg/m l舒芬太尼+80μg/m l恩丹西酮;S3组:1.5μg/m l舒芬太尼+80μg/m l恩丹西酮。应用PCA泵LCP给药模式设置:总量100 m l,背景输注2 m l/h,PCA 2 m l,锁定时间30 m in。观察术后4、8、12、24、48 h各时间点的镇痛效果和不良反应。结果镇痛效果S1组较差(P<0.05),S2、S3组相当;镇静、恶心呕吐发生率S1、S2组低于S3组(P<0.05)。结论1.2μg/m l的舒芬太尼为合适镇痛浓度,可安全有效地用于脊柱手术术后PCIA的镇痛治疗。

Objective To observe the effects of sulfentanil with different concentrations in patients controlled intravenous analgesia （PCIA）. after spinal operation, determine the best concentration of sulfentanil. Methods Ninty patients after spinal operation were randomly divided into three groups with 30 cases each. The patients in group St received 1.0 μg/ml sulfentanil plus 80 μg/ml ondansetron, in group S2 1.2 μg/ml sulfentanil plus 80 μg/ml ondansetron , in group S3 1.5 μg/ml sulfentanil plus 80 μg/ml ondansetron. PCIA parameters were a bolus dose of 2ml, lockout interval of 30 minutes and continuous infusion of 2 ml/h. Visual analogue scales（VAS） and adverse effects were observed at 4,8,12,24 and 48h postoperatively. Results Pain score was higher in group S1 than that in group S2 and group S3 （ P 〈 0.05 ）, no significantl difference between group S2 and group S3. Sedation score and the incidence of adverse effects such as nausea and vomiting lower ingroup S1 and group S2 than that in group S3 （ P 〈 0.05 ）. Conclusion PCIA with 1.2μg/ml sulfentanil can provide a good postoperative analgesia and use safely in spinal surgical patients.