不同位置皮下给予舒芬太尼在术后镇痛中的应用效果

Application effects of subcutaneous administration of sufentanil at different locations in postoepative analgesia

目的：比较不同位置皮下给予舒芬太尼在术后皮下自控镇痛（PCSA）中的临床效果和安全性。方法选择1000例术后行PCSA患者随机分为前臂组（A组）和三角肌组（B组），每组各500例，PCSA设置：无负荷量、维持量1.0~2.5 ml/h、追加量0.5~1.5 ml/h、PCA时间10 min、维持48 h。记录术后6、12、24、48 h的VAS、Ramsay评分、不良反应发生情况及留置针情况。结果两组患者的镇痛效果及不良反应发生率差异均无统计学意义（P〉0.05）；两组留置针脱落率差异有统计学意义（P〈0.05）。结论前臂法和三角肌法舒芬太尼PCSA同样安全有效，但发生前臂给药留置针脱落的情况明显较少，可减少回访压力，减少医患纠纷，更适合临床使用。

Objective To compare the clinical effects and safety of the subcutaneous administration of sufentanil at dif-ferent locations in the postoperative PCSA. Methods 1000 patients receiving postoperative PCSA were selected and randomly divided into the forearm group （group A） and the deltoid group （group B）,with 500 cases in each group.The PCSA settings were no load,maintaining dose of 1.0-2.5 ml/h,additional dose of 0.5-1.5 ml/h,PCA time of 10 minutes and maintaining 48 hours.The postoperative 6,12,24 and 48-hour VAS,Ramsay scores,adverse reactions and remaining needle conditions were recorded. Results The two groups were not statistically different in the analgesic effects and in-cidence of adverse reactions （P〉0.05）.The two groups were significantly different in the fall rate of remaining needle, with statistical significance （P〈0.05）. Conclusion Both forearm and deltoid administration of sufentanil is safe and ef-fective,but forearm administration shows less remaining needle fall,can reduce return visit pressure and reduces medical dispute,which is suitable for clinical use.