舒芬太尼与丁丙诺啡在口腔外科术后镇痛的比较

Comparison of the postoperative analgesic efficacy between sufentanil and buprenorphine in patients undergoing oral surgeries

目的比较等效剂量丁丙诺啡与舒芬太尼在口腔外科术后镇痛的效果。方法 60例ASAⅠ或Ⅱ级口腔外科术病人依病历号奇偶数分为舒芬太尼组(S)与丁丙诺啡组(B),每组30例。两组均采用静脉自控镇痛(PCIA)给药,S组舒芬太尼50μg,B组丁丙诺啡0.6mg,总量100ml,首次负荷剂量4ml。术后5、10、20及40h行VAS疼痛与Ramsay运动评分,记录PCA有效按压次数及不良反应发生率。结果两组VAS疼痛评分、Ramsay运动评分及PCA有效按压次数差异均无统计学意义,而不良反应发生率B组显著高于S组(P<0.05或P<0.01)。结论等效剂量舒芬太尼与丁丙诺啡用于口腔外科术后镇痛效果相当,但舒芬太尼不良反应发生率较低,更适合口腔外科术后镇痛使用。

Objective To compare the analgesic efficacy of equivalent buprenorphine and sufentanil in patients undergoing oral surgeries. Methods Sixty patients with ASA Ⅰ or Ⅱ scheduled for oral surgeries were divided into sufentanil group （S） and buprenorphine group （B） with 30 cases each according to the odd-even property of their enrollment IDs. Both groups received patient-controlled intravenous analgesia （PCIA）, drugs in the group S was sufentanil 50 μg and buprenorphine 0. 6 mg in the group B, total volume was 100 ml, loading bolus was 4 ml. The pain intensity was scored with visual analog scale （VAS）, and motor was assessed with Ramsay scale at 5, 10, 20 and 40 h after operation, and the effective PCA boluses and rate of side effects were recorded. Results No significant difference was observed between the two groups in the VAS and Ramsay scales and PCA boluses, but side effects in the group B were more than that of the group S （P〈0.05 or P〈0.01）. Conclusion Equivalent sufentanil and buprenorphine produce similar analgesic efficacy, but the incidence of side effect of sufentanil is lower. So sufentanil is more suitable than buprenorphine for postoperative analgesia in oral surgeries.