不同剂量苏芬太尼用于腹部手术术后患者皮下自控镇痛的临床研究

Clinical study on the controlled subcutaneous analgesia with different doses of sufentanil for postoperative abdominal surgery patients

目的观察不同剂量苏芬太尼用于腹部手术术后患者皮下自控镇痛（PCSA）的临床效果及不良反应。方法90例择期腹部手术的患者，随机分为三组各30例。Ⅰ组：术后镇痛给与苏芬太尼0．04μg／kg；Ⅱ组：给与苏芬太尼0．06μg／kg；Ⅲ组：给与苏芬太尼0．08μg／kg。手术结束后于患者三角肌处埋针置管连接镇痛泵。分别记录术后4、8、16、24和48h各时点的疼痛评分（VAS评分），镇静评分（Ramsay评分）及不良反应发生情况。结果与I组相比，Ⅱ组和Ⅲ组VAS评分显著降低（均P〈0．05）Ⅱ组和Ⅲ组问VAS评分差异无统计学意义（P〉0．05）；各组Ramsay评分组间差异无统计学意义（均P〉0．05）；Ⅲ组不良反应多于Ⅰ组和Ⅱ组（P〈0．05）。结论苏芬太尼（0．06μg／kg）用于腹部手术术后患者皮下自控镇痛效果确切，不良反应少．更适合于临床推广。

Objective To investigate the effects of controlled subcutaneous analgesia（PCSA） with sufentanil in patients underwent abdominal surgery and the occurrence of adverse reactions. Methods 90 patients underwent abdominal surgery were randomly divided into three groups with 30 cases each. Group Ⅰ ：sufentanil 0. 04μg· kg-1·h-1 for postoperative analgesia; Group Ⅱ： sufentanil 0.06μg· kg-1·h-1 for postoperative analgesia; Group Ⅲ ： sufentanil 0.08μg· kg-1·h-1for postoperative analgesia;PCSA started at the end of operation with catheter buried in del- toid muscle. Visual analgesia scale （VAS）, Rasmay scale and side effects were recorded at 4,8,16,24 and 48h after operation. Results VAS scores decreased significantly in group Ⅱ and group Ⅲ compared with that in group Ⅰ （ all P 〈 0.05 ） ;There were no differences of Ramsay scores between groups（ all P 〉 0.05） ;There were three cases of respiratory depression in group Ⅲ. Conclusion PCSA with sufentanil （0. 06μg/kg） had exact analgesic effects for postoperative abdominal surgery patients with less adverse reactions.