新疆汉、哈族胃癌根治术患者术后舒芬太尼镇痛效果的比较

COMPARISONS OF EFFECT OF SUFENTANIL ON POSTOPRATIVE ANALESIA BETWEEN PATIENTS OF HAN AND KAZAK PEOPLE AFTER RADICAL GASTRECTOMY

目的:探讨新疆汉、哈民族差异对胃癌根治术患者舒芬太尼术后镇痛的影响。方法:选择ASAⅠ或Ⅱ级择期行胃癌根治术的全麻患者50例,按民族分为两组:汉族组(H组)、哈族组(K组),每组25例,术后分别接受舒芬太尼持续静脉镇痛,记录并比较术后6、12、24、48 h的疼痛视觉模拟评分(VAS)、Ramsay镇静评分、生命体征及不良反应,48 h PCA总按压次数、有效按压次数和舒芬太尼用量。结果:两组患者各时间点MAP、SpO2、Ramsay评分和VAS评分比较差异无统计学意义(P>0.05);K组PCA总按压次数(次)、有效按压次数(次)和舒芬太尼总用量(μg)分别为(20.54±6.35)、(12.24±3.28)、(114.36±20.52)均明显多于H组分别为(12.70±3.27)、(8.36±2.53)、(85.84±15.37)(P<0.05);与H组3例(12%)比较,K组6例(26%)术后恶心呕吐(PONV)发生率明显增多(P<0.05)。结论:哈族与汉族患者术后镇痛舒芬太尼需要量存在明显差别,临床用量需要考虑民族差异的影响。

Objective：To investigate the ethnic differences between Han and Kazak People on the analgesic efficacy of postoperative sufentanil in patients who had radical gastrectomy surgery.Methods：Fifty ASA Ⅰ or Ⅱ patients undergoing radical gastrectomy under general anesthesia were evenly assigned to Han group （group H） and Kazak group （group K） according to their nationality.Patients were treated with continuous intravenous analgesia with sufentanil after surgery.Visual analog scale （VAS） score,Ramsay sedation scale score,the vital signs at 6,12,24 and 48 h after operation and the total consumption of sufentanil,the total number and the valid number of pressing PCA pump,and the adverse effects 48 h after operation were recorded and compared.Results：There were no differences in the MAP,SpO2,Ramsay scores and VAS scores at each time point of patients between the two groups （P ＞ 0.05）.The total comumption of sufentanil （μg）,the total number and the valid number of pressing PCA pump （times） in group K were （20.54±6.35）,（12.24±3.28） and （114.36±20.52）,which were significantly higher than those of group H （12.70±3.27）,（8.36±2.53）and（85.84± 15.37）（P ＜ 0.05）.Compared with group H （12％）,the occurrence rate of PONV in group K （26％）were significantly higher （P ＜ 0.05）.Conclusion：There is a significant difference in postoperative Sufentanil analgesic dosage between group H and group K.The influence of nationality on recommended dosage of Sufentanil should be considered.