舒芬太尼和芬太尼用于妇科术后患者静脉自控镇痛的比较性研究

Comparison of sufentanil with fentanyl in patient-controlled intravenous analgesia after gynecological surgery

目的对比观察舒芬太尼和芬太尼用于妇科术后患者静脉自控镇痛的效果及安全性。方法选择妇科手术后成年患者40例实施患者静脉自控镇痛(PCIA),随机均分为2组:芬太尼组,应用芬太尼0.2μg·kg^(-1)·h^(-1);舒芬太尼组,应用舒芬太尼0.02μg·kg^(-1)·h^(-1)。记录术后PCA治疗期间患者的生命体征及2、4、8、12、24、48 h各时间点患者的镇痛和镇静评分;术后48 h内两组患者的PCA有效按压次数及是否使用镇痛药物;观察记录术后恶心、呕吐、呼吸抑制、皮肤瘙痒、尿潴留、排气延迟等并发症,并记录患者对PCIA治疗的满意度。结果与芬太尼组相比较,舒芬太尼组的VAS评分和镇静评分在术后48 h内各时间点的差异均无统计学意义。舒芬太尼组的PCA有效按压次数明显少于芬太尼组(P<0.05);两组无1例患者在PCA期间发生呼吸抑制、皮肤瘙痒和尿潴留,恶心、呕吐的发生率两组间无统计学差异。结论与芬太尼相比较,舒芬太尼能够更安全有效地用于妇科术后患者静脉自控镇痛。

Objective To compare the clinical efficacy and safety of sufentanil with fentanyl in patient-controlled intravenous analgesia （PCIA） after gynecological surgery. Methods Forty female patients, ASA Ⅰ -Ⅱ , scheduled for gynecological surgery and requiring PCIA, were randomly allocated to one of the following two groups： patients in groups fentanyl and sufentanil were received fentanyl 0.2 μg· kg^-1·h^-1 and sufentanil 0.02μg· kg^-1·h^-1 respectively . Visual analogue scale （VAS, 0-10） and sedation scores were recorded at 2, 4, 8, 12, 24, 48 h after PCIA. The changes of circulation and respiration, times of PCA, supplementary analgesics, side effects and the patients＇ satisfactory degree were observed. Results Compared with fentanyl group, VAS and sedation scores in group sufentanil at each point in 48 hours were no statistical differences. The times of PCA was lower in group sufentanil compared with group fentanyl （P〈0.05）. During PCIA, there was no respiratory depression and pruritus happened. The incidences of nausea, vomiting in two groups were no significant differences. Conclusion PICA with sufentanil after gynecological surgery is more effective and safe compared with fentanyl.