芬太尼与舒芬太尼在胸外科术后镇痛治疗的对比  

Comparative Study of Sufentanil and Fentanyl on Patients Undergoing Thoracic Surgery

作　　者：沈亚建[1] 

机构地区：[1]浙江省肿瘤医院麻醉科,浙江杭州310022

出　　处：《中国现代医生》2011年第20期91-93,共3页China Modern Doctor

摘　　要：目的观察比较等剂量的舒芬太尼和芬太尼在胸外科术后患者自控静脉镇痛(PCIA)的效果和不良反应。方法选择胸外手术患者40例,随机分为舒芬太尼组(20例)和芬太尼组(20例),手术结束后接美国百特AP型镇痛泵行PCIA,舒芬太尼组给予舒芬太尼2.8μg/kg,生理盐水稀释至100mL;芬太尼组给予芬太尼28μg/kg,生理盐水稀释至100mL。背景剂量2mL/h,单次给药量0.5mL,锁定时间位15min。记录患者术后24h、48h的静态疼痛视觉模拟评分(VASr)、动态疼痛视觉模拟评分(VASm)、警觉/镇静(OAA/S)评分、血氧饱和度(SpO2)、呼吸频率、心率、平均动脉压、PCIA有效按压次数、镇痛药物消耗量及不良反应发生率。结果舒芬太尼组术后24h、48h的VASr评分及VASm评分、PCIA有效按压次数均明显低于芬太尼组(P<0.05),24h时OAA/S评分高于芬太尼组(P<0.05)。两组镇痛药物消耗量差异无统计学意义(P>0.05)。两组患者术后在呼吸频率、心率、平均动脉压方面的差异无统计学意义(P>0.05),但舒芬太尼组在术后24h、48h血氧饱和度明显高于芬太尼组,差异有统计学意义(P<0.05)。舒芬太尼组不良反应发生率明显低于芬太尼组,两者差异有统计学意义(P<0.05)。结论与等效剂量的芬太尼相比,舒芬太尼更加适用于胸外科术后PCIA镇痛。Objective To evaluate the clinical efficacy of sufentanil and fentanyl at equivalent dose for patient-controlled intravenous analgesia （ PCIA ） after thoracotomy. Methods Forty patients undergoing thoracic surgery were randomly divided into sufentanil intravenous analgesia group and fentanyl intravenous analgesia group. The pain intensity according to VASr, VASm, the observer＇ s assessment of alertness/sedation （ OAA/S ）, cumulative analgesic consumption, PCIA button pressing times and side effects at 24 and 48 hours after administration were recorded. SpO2, respiratory rate, ECG and blood pressure were continuously monitored. Results There were no significant differences in CAC, RR, heart rate and mean arterial pressure between the two groups （P 〉 0.05 ）. But the VASr and VASm were lower in sufentanil group than in fentanyl group （ P 〈 0.05 ）. And the SpO2, OAA/S, PCIA button pressing times, occurrence rate of adverse reaction were superior in sufentanil group （P 〈 0.05 ）. Conclusion PCIA with sufentanil provides better efficacy of analgesia and sedation than with fentanyl in postoperative patients with thoracotomy.

关 键 词：舒芬太尼 芬太尼 胸外科 患者自控静脉镇痛 

分 类 号：R614[医药卫生—麻醉学]