舒芬太尼与芬太尼PCA用于面神经显微血管减压术后镇痛的对照研究

THE ANALGESIC EFFECT OF SUFENTANIL ON THE PATIENTS AFTER MICROVASCULAR DECOMPRESSION

目的对舒芬太尼和芬太尼PCA用于面神经显微血管减压术(MVD)后镇痛的疗效、安全性及其副作用进行对照分析。方法将62例MVD术后患者随机分为舒芬太尼组(S组,n=32)和芬太尼组(F组,n=30),分别使用舒芬太尼和芬太尼进行术后PCA。记录术后1 h6、h1、2 h、24h4、8 h7、2 h各时间点的疼痛评分、镇静评分、生命体征、副作用以及PCA需求按压和有效按压次数及结束PCA治疗后患者总体满意度。结果术后12 h时安静痛VAS评分S组小于F组(P<0.05),术后48 h时S组PCA需求按压及有效按压次数少于F组(P<0.05),两组患者各时间点间镇静评分以及并发症发生率均无显著性差异(P>0.05);结束PCA后两组患者总体满意度均较高且无显著性差异(P>0.05),但很满意率S组高于F组。结论舒芬太尼和芬太尼PCA用于面神经显微血管减压术后镇痛时安全有效,等效剂量舒芬太尼镇痛镇静效果强于芬太尼。

Objective To investigate the clinical efficacy, complication and safety of sufentanil through patient controlled analgesia （PCA） after microvascular decompression （MVD）. Methods Sixty two patients undergoing MVD were divided randomly into sufentanil（S） group（n= 32） and fentanyl（F） group（n= 30） after MVD. PCA with sufentanil or fentanyl was administered after MVD. The following variables were recorded at time intervals of 1h, 6h, 12 h, 24 h, 48h, 72h after the administration of PCA. Results There were no significant differences between the two groups in view of the sedation score, complications and patient satisfaction（ P 〉0.05）, however, the pain visual analogue scale（VAS） and requested dose of sufentanil at some intervals are less than those of fentanyl（ P 〈0.05） and the rate of patient satisfaction was higher in Group S than that of Group F. Conclusion PCA with sufentanil is effective and safe for the treatment of postoperative pain after MVD, the effect of analgesia and sedation of sufentanil is better than that of fentanyl.