舒芬尼在腹部肿瘤患者术后自控静脉镇痛中的应用

The Application of Sufentanil in Postoperative Patient-controlled Intravenous Analgesia for Patients with Abdominal Tumors

  • 摘要: 目的:以芬太尼为对照,比较不同剂量舒芬尼用于腹部肿瘤手术患者PCIA的优劣。方法:ASAⅠ~Ⅱ级腹部肿瘤手术80例随机分为4组,每组20例。术后PCIA:Ⅰ、Ⅱ、Ⅲ组分别为舒芬尼0.02、0.03、0.04μg/kg·ml,Ⅳ组为芬太尼0.3μg/kg·ml,镇痛不全者加用哌替啶50mg肌注/次。记录各组使用镇痛泵4、24、48、72小时的VAS值、Ramsay评分,呼吸、血氧变化和恶心、呕吐情况及术后3天每天的镇痛液和哌替啶用量。结果:1)VAS评分:Ⅰ组各时点评分均明显高于其他组(P<0.01);2)Ramsay评分:Ⅰ组术后4、24小时评分低于其他各组(P<0.05),Ⅲ组术后48、72小时评分高于其他各组(P<0.05);3)Ⅳ组恶心呕吐发生率高于Ⅰ、Ⅱ组(P<0.05),呼吸抑制发生情况高于其他各组(P<0.05);4)Ⅰ组术后1、2天镇痛液用量和术后第1天哌替啶消耗量明显高于其他各组(P<0.01)。结论:舒芬尼用于腹部肿瘤手术患者术后PCIA,0.3μg/kg·ml效果良好,少数患者可增加药量,但一般不超过0.4μg/kg·ml。

     

    Abstract: Objective: To compare different doses of sufentanil in postoperative patient-controlled intravenous analgesia (PCIA)for patients with abdominal tumors. Methods: Eightypatients (ASA Ⅰ~Ⅱ) with abdominal tumors were divided into 4 groups with 20 patients each. Sufentanil was administered at 0.02, 0.03 and 0.04μg/kg·ml in group Ⅰ to Ⅲ, respectively, and fentanyl was administered at 0.3μg/ kg·ml in group Ⅳ. A 50mg / time dose of pethidine was added for patients with incomplete analgesia. The related data were recorded, e.g. the VAS value, Ramsay score, change in respiration rates and pulse oxygen saturation (SpO2) and the status of nausea and vomiting at 4, 24, 48 and 72 h after using the analgesia pump, as well as the daily volume of use for analgesia liquid and pethidine 3 days after surgery. Results: a). The VAS scores at each time point in group Ⅰ were obviously higher than that in the other groups (P<0.01); b). The Ramsay scores at 4 and 24 h after operation in group Ⅰ were lower than those in the other groups (P<0.05) and the scores at 48 and 72 h after operation in group Ⅲ were higher compared to the other groups (P<0.05). c). The incidence of nausea and vomiting was higher in group Ⅳ than in groups Ⅰ and Ⅱ (P<0.05), and the incidence of respiratory depression was higher compared to the other groups (P<0.05). d). The consumption of analgesia liquid 1 and 2 days after surgery and that of pethidine 1 day after surgery was significantly higher in group Ⅰ compared to that in other groups (P<0.01). Conclusion: Sufentanil is suitable for postoperative PCIA in patients with abdominal tumors, and a dose of 0.3μg/kg·ml has obtained good results. The dosage can be increased in a fewpatients but should be less than 0.4μg/kg·ml in general.

     

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