舒芬太尼用于急性创伤后镇痛

Sufentanil for analgesia after acute trauma

目的探讨舒芬太尼用于急性创伤后镇痛的可行性和安全性。方法 60例ASAⅠ或Ⅱ级、视觉模拟量表(VAS)评分大于8分的肢体创伤急诊患者随机分为两组,每组30例。舒芬太尼组和吗啡组术前分别静脉注射舒芬太尼0.15μg·kg-1或吗啡0.1mg·kg-1,给药后5 min(T1)、10 min(T2)、15 min(T3)评估VAS评分和Ramsay镇静评分,观察记录镇痛、镇静效果,生命体征及不良反应发生情况。结果给药后,两组各观察时点VAS评分均下降(P<0.05),T1时舒芬太尼组VAS评分低于吗啡组(P<0.05),T2、T3时组间无显著差异(P>0.05)。两组各时点Ramsay镇静评分无显著差异(P>0.05),均未发生过度镇静,患者均有短暂轻微眩晕发生。两组患者给药后呼吸频率和脉搏血氧饱和度(Sp O2)均降低(P<0.05),T2、T3时舒芬太尼组Sp O2高于吗啡组(P<0.05)。结论舒芬太尼可用于急性创伤后镇痛,起效快,效果与吗啡相当,不良反应轻微。

AIM To discuss the analgesia action and safety of sufentanil after acute trauma. METHODS Sixty cases of limb trauma patients（ ASA grade Ⅰ and Ⅱ） whose visual analog scale（ VAS） score were greater than 8 points were randomly divided into two groups, 30 cases each. The patients in the sufentanil group were given sufentanil 0.15 μg·kg-1, and the other patients in the morphine group were given morphine 0.1 mg·kg-1.The VAS scores, Ramsay sedation score and adverse reactions were observed and recorded at 5 min（T1）, 10 min（T2）, 15 min（T3） after administration. RESULTS The VAS scores of two groups were significantly decreased after administration（ P 0.05）. The VAS scores of the sufentanil group was lower than that of the morphine group at T1（P 0.05）. There was no significant difference in VAS score between two groups at T2 and T3（P 0.05）. And there was no significant difference in Ramsay sedation score between two groups at each point（P 0.05） and no excessive sedation occurred in both groups, but with transient mild vertigo. RR and Sp O2 were significantly reduced after administration in two groups（P 0.05）. And Sp O2 of the sufentanil group was higher than that of the morphine group at T2 and T3（P 0.05）. CONCLUSION Sufentanil can be used for analgesia after acute trauma, with short onset time, similar analgesic effect to morphine and mild adverse reactions.