舒芬太尼应用于非体外循环冠状动脉旁路移植术后镇痛效果的研究

Effects of sufentanil on postoperative pain control for patients undergoing off-pump coronary artery bypass surgery

目的:评价舒芬太尼应用于非体外循环冠状动脉旁路移植术(OPCABG)后镇痛的效果。方法:选择行OPCABG术患者130例,随机分成2组,试验组:舒芬太尼(Sufentanil)镇痛组(A组,n=65例)和对照组:地佐辛(Dezocin)镇痛组(B组,n=65例)。A组静脉持续输注舒芬太尼镇痛液2 mL/h,2.5μg/mL,B组持续静脉输注地佐辛镇痛液2 mL/h,25μg/mL。观察指标:疼痛评分:术后16 h、24 h、48 h、拔除镇痛泵后12 h,采用视觉模拟评分法(VAS)进行镇痛效果评分、镇静效果评分(Ramsay)。结果:1.手术后VAS法评分:2组都在4分以下,差异无统计学意义(P>0.05)。2.手术后2组患者的镇静评分(Ramsay评分):差异无统计学意义(P>0.05)。拔泵以后舒芬组有5例轻微躁动,地佐辛组有3例,但差异无统计学意义(P>0.05)。3.2组患者PCA次数在手术后16 h:地佐辛组比舒芬太尼组多,差异有统计学意义(P<0.05)。4.镇痛期间不良反应:2组患者恶心、呕吐、尿储留的发生率差异无统计学意义(P>0.05),A组中有17例患者有眩晕,B组中有9例,差异有统计学意义(P<0.05)。结论:舒芬太尼用于OPCABG患者术后镇痛效果优于地佐辛,其恶心、呕吐、尿潴留的发生率差异无统计学意义,但患者术后眩晕的发生率舒芬太尼高于地佐辛。

Objective：To evaluate the effects of sufentanil on postoperative pain control for patients undergoing off-pump coronary artery bypass grafting surgery.Methods：130 patients undergoing elective off-pump coronary artery bypass grafting were randomly divided into two groups（Group A and Group B）： patients in group A received intravenous infusion of sufentanil for postoperative analgesia from the end of the operation（containing sufentanil 2.5 μg/mL,infusion rate=2.5 mL/h,n=65）,while group B received intravenous infusion of dezocin（infusion rate=2.5 mL/h,containing dezocin 25μg/mL,n=65）.The Visual analog scale（VAS） and ramsay sedation scores（RSS） were measured at 16h,24h,48h postoperatively and 16h after the remove of patient-controlled analgesia（PCA） device respectively.The adverse reactions of analgesia were recorded.Results：Patients in the two groups achieved satisfied analgesia postoperatively with the VAS value all below 4.There were no difference in VAS value and the RSS value between the two groups（P〉0.05 respectively）.The total number of PCA pressing were higher in group B than that of group A at 16h after remove of the PCA device.The occurrence of postoperative nausea,vomiting and urinal retention showed no difference in two groups.Patient in group B experienced more dizziness when compared with group A（P〈0.05）.Conclusion：Sufentanil showed better effect of postoperative pain control in patients after off-pump coronary bypass grafting with less dizziness and similar occurrence rate of postoperative nausea,vomiting and urinal retention comparing with dezocin.