舒芬太尼术后静脉自控镇痛效果的临床观察

Clinical Observation of Sufentanil in Intravenously Patient-controlled Analgesia after Surgery

【目的】探讨舒芬太尼在术后静脉自控镇痛的疗效、不良反应及最佳剂量。【方法】将本院180例全麻下行腹部手术的患者随机分为A、B、C组,将舒芬太尼由镇痛泵行静脉自控镇痛,剂量分别为1μg/kg、2μg/kg、3μg/kg,对三组患者术后4、12、48h的视觉模拟评分(VAS)、镇静评分和不良反应进行比较。【结果】B、C组术后各时点VAS评分显著低于A组(P<0.05),B、C组之间无显著差异(P>0.05);C组镇静评分显著高于A、B组(P<0.05),A、B组之间无显著差异(P>0.05);术后C组恶心呕吐不良反应发生高于A、B组。【结论】舒芬太尼用于术后静脉自控镇痛,具有镇痛效果确切,镇静作用适度,血流动力学稳定,简单、安全、副反应少等优点,最佳剂量为2μg/kg。

[Objective]To study the efficacy, adverse reactions and optimal dose of sufentanil in intravenously patient-controlled analgesia after surgery. [Methods] In our hospital, 180 cases und.ergoing abdominal surgery with general anesthesia were randomly divided into group A, B and C. Sufentanil was conducted by intravenously patient-controlled analgesia via the pump with doses of 1μg/kg, 2μg/kg and 3μg/kg, respectively. The visual analogue scale （VAS）, sedation score and adverse reactions in 4h, 12h and 48h after surgery in three groups were compared. [Results]The VAS score at each time point after surgery in Group B and C was significantly lower than that in Group A （ P 〈0.05）, and there was no significant difference between Group B and C （ P〈0.05）. The sedation score in Group C was significantly higher than that in Group A and B （ P〈0.05）, and there was no significant difference between Group A and B （ P 〉0.05）. The incidence of nausea and vomiting in Group C was higher than that in Group A and B after surgery. [Conclusion]Sufentanil in intravenously patient-controlled analgesia after surgery has the advantages such as precise analgesic effect, proper sedation, hemodynamic stability, simple, safe and less side reactions, and its optimal dose is 2μg/kg.