舒芬太尼在上腹部手术后静脉自控镇痛中的临床应用

Clinical Application of Sufentanil in Postoperative Patient-controlled Intravenous Analgesia for Patients with Upper Abdominal Surgery

目的探讨舒芬太尼用于上腹部手术后病人静脉自控镇痛(PCIA)的有效性及安全性。方法选择90例上腹部择期手术病人,随机分为3组,每组30例,术后静脉镇痛分别使用舒芬太尼1.5μg/ml(A组)、舒芬太尼1.0μg/ml(B组)及芬太尼10μg/ml(C组)。记录术后第4、8、20、24、48小时的镇痛效果,镇静程度,恶心呕吐反应及血氧饱和度,呼吸频率,病人自控按压次数等数据。结果与B、C组比较,A组VAS评分降低,差异有显著性,B、C组比较,VAS评分差异无显著性。结论舒芬太尼适用于上腹部手术后PCIA。镇痛效果好,副作用小,其1.5ug/ml浓度则更佳。

Objective To compare the clinical effect and safety of different concentration of sufentanil for patient-controlled intravenous analgesia（PCIA） after upper abdominal surgery. Methods Ninety patients undergoing upper abdominal surgery were assigned with random and double-blind method to three groups for receiving PCIA with sufentanil 1.5μg/ml（ group A, n = 30） , sufentanil 1.0μg/ml （ group B, n = 30） and fentanyl 10 μg/ml （ group C, n = 30 ）. Visual analogue scales （VAS） , sedation, side-effects including nausea and emesis ,SPO2 ,respiration rate and pressure times were assessed after the 4th ,8th, 12th ,20th and 48th hour of postoperative analgesia. Results After 48h of postoperative analgesia, VAS scores in group A were lower than that in group B and C （p 〈 0.05）. VAS scores in group B and C were equivalent （p 〉0.05）. Conclusions Sufentanil is suitable for PCIA after upper abdominal surgery,the side-effects is small and the dose of sufentanil 1.5μg/ml can obtained a better postoperative analgesia.