Lin Chun-shui, Lu Gang, Ruan Luo-yang, Gu Miao-ning
Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2006 Feb;26(2):240-1, 244.
To evaluate the clinical efficacy of sufentanil and fentanyl at equivalent dose for patient-controlled intravenous analgesia (PCIA) after thoracotomy.
Sixty ASA I-II patients (20-60 years of age) undergoing radical operation for lung or esophageal cancer were randomly divided into sufentanil intravenous analgesia group (group S, with sufentanil 1 microg/ml) and fentanyl intravenous analgesia group (group F, fentanyl 10 microg/ml). PCIA was administered with background infusion of 2.5 ml/h, bolus injection of 2.5 ml and lockout time of 15 min. The pain intensity according to visual analogue scale (VAS), cumulative analgesic consumption (CAC), sedative scores and side effects at 24 and 48 h after administration were recorded. SpO(2), respiratory rate (RR), blood pressure (BP) and ECG were continuously monitored.
There were no significant differences in CAC between the two groups, but he VAS was lower in group S than in group F (P<0.05) and the sedative efficacy was superior in group S (P<0.05). The incidence of nausea and vomiting in group S was lower than that in group F (P<0.05). No significant differences were observed in SpO(2), RR, heart rate and mean arterial pressure between the two groups.
PCIA with sufentanil provides better efficacy of analgesia and sedation with lower incidence of nausea and vomiting than with fentanyl in postoperative patients with thoracotomy.
评估等效剂量舒芬太尼和芬太尼用于开胸术后患者自控静脉镇痛(PCIA)的临床疗效。
60例年龄在20至60岁之间、美国麻醉医师协会(ASA)分级为I-II级、行肺癌或食管癌根治术的患者,随机分为舒芬太尼静脉镇痛组(S组,舒芬太尼浓度为1微克/毫升)和芬太尼静脉镇痛组(F组,芬太尼浓度为10微克/毫升)。PCIA背景输注速度为2.5毫升/小时,单次给药量为2.5毫升,锁定时间为15分钟。记录给药后24小时和48小时时根据视觉模拟评分法(VAS)得出的疼痛强度、累计镇痛药物消耗量(CAC)、镇静评分及不良反应。持续监测血氧饱和度(SpO₂)、呼吸频率(RR)、血压(BP)和心电图。
两组的CAC无显著差异,但S组的VAS低于F组(P<0.05),且S组的镇静效果更佳(P<0.05)。S组恶心呕吐的发生率低于F组(P<0.05)。两组间SpO₂、RR、心率和平均动脉压无显著差异。
与芬太尼相比,舒芬太尼用于开胸术后患者的PCIA时,镇痛和镇静效果更好,恶心呕吐发生率更低。