开胸手术后应用舒芬太尼与芬太尼自控静脉镇痛的临床观察  

DIFFERENT CONCENTRATION OF SUFENTANIL AND FENTANYL FOR POSTOPERATIVE PATIENT-CONTROLLED INDUCE ANALGESIA AFTER THORACIC OPERATZON A RANDOMIZED,DOUBLE-BLIND COMPARISON

作　　者：郭瑞宏[1] 

机构地区：[1]北京市密云县医院麻醉科,北京101500

出　　处：《中国疼痛医学杂志》2006年第4期221-223,共3页Chinese Journal of Pain Medicine

摘　　要：目的:对比观察胸科手术后应用不同剂量舒芬太尼与芬太尼自控静脉镇痛的临床效果和安全性。方法:45例择期开胸行肺叶、食管肿瘤切除术后病人,采用随机双盲方法分为3组,术后自控静脉镇痛分别使用芬太尼10μg/m l(A组)、舒芬太尼1μg/m l(B组)和舒芬太尼1.25μg/m l(C组)。分别于术后6小时、12小时、24小时和48小时观察病人的VAS评分、VAFS评分、患者满意度评分、辅助药用量、生命体征(MAP、HR、RR、SpO2)、镇静评分以及不良反应(恶心、呕吐、皮肤瘙痒、呼吸抑制等)。结果:术后48小时内VAS评分,组间比较显示,B组的VAS评分明显高于A组(P<0.05)和C组(P<0.01)。组内各时间点比较,VAS评分在术后12小时,B组明显高于A组(P<0.01)和C组(P<0.01),在术后24小时,B组高于C组(P<0.05);VAFS评分在术后12小时,B组高于C组(P<0.05),明显高于A组(P<0.01)。术后镇痛总体满意度评分B组差于A组(P<0.05),明显差于C组(P<0.01)。三组病人术后生命体征、镇静评分、恶心、呕吐、皮肤瘙痒等不良反应发生率低。结论:舒芬太尼1.25μg/m l与芬太尼1μg/m l比较,镇痛效果相当。Objective： To compare the clinic effect and safety of different concentration of sufentanil and fentanyl for postoperative patient-controlled induce analgesia after thoracic operation. Methods： Forty-five patients undergoing thoracic surgery were assigned to groups receiving patient-controlled induce analgesia （PCIA） with fentanyl 10μg/ml （ A, n = 15 ）, sufentanil 1 p,g,/ml （ B, n = 15 ）, sufentanil 1.25 p,g,/ml （ B, n = 15 ）. Visual analogue scale（ VAS）, VAFS, satisfaction, sedation scores at rest and on movement, vital signs（ MAP, HR, RR, SpO2） and side-effects including nausea, emesis, pruritus and resperitory inhibition were assessed after 6,12,24 and 48 h of postoperative analgesia. Results： After 48h of postoperative analgesia, VAS scores were higher in group B than group A and group C（P 〈0.05 or P 〈0.01 ）. After 12 h of postoperative analgesia, VAS scores were higher in group B than group A and group C （P 〈 0.01 ）, After 24 h of postoperative analgesia, VAS scores were higher in group B than group C （ P 〈 0. 01 ）. After 12 h of postoperative analgesia, VAFS scores were higher in group B than group C and group A（P 〈0.05 or P 〈 0.01 ）. The scores of satisfaction of postoperative analgesia were lower in group B than group C and group A （ P 〈 0.05 or P 〈 0.01 ）. The incidence of adverse events including sideeffects （ nausea, emesis, pruritus and resperitory inhibition） is lower. Conclusion ： Sufentanil 1.25 μg/ml and fentanyl 10 μg/ml provide the same analgesia effect.

关 键 词：舒芬太尼 芬太尼 静脉镇痛 病人自控 视觉模拟评分法 

分 类 号：R614[医药卫生—麻醉学]