苏芬太尼与芬太尼用于术后患者自控镇痛的效果比较

目的 比较苏芬太尼与芬太尼用于术后患者自控镇痛的临床疗效.方法 60例ASA Ⅰ～Ⅱ级择期腹部手术患者随机分为两组,每组30例.两组麻醉诱导和用药方式相同,手术结束时均给予芬太尼0.02 mg和氟哌利多1.5 mg静脉注射.然后行患者自控静脉镇痛(PCIA),苏芬太尼组与芬太尼组分别给予苏芬太尼0.1 mg和芬太尼1.0 mg,以0.9％氯化钠注射液稀释至100 ml,静脉泵入.观察术后48 h内两组VAS评分、镇静评分以及不良反应.结果 苏芬太尼组术后4、8h的VAS评分为低于芬大尼组(均P＜0.05),镇静评分高于芬太尼组(均P＜0.05).两组患者PCIA按压次数、不良反应发生率差异无统计学意义(均P＞0.05).结论 苏芬太尼与等效剂量芬太尼相比,镇痛作用更加完善,镇静作用强于芬太尼,用于术后静脉镇痛安全、有效.

Effects of sufentanil and fentanyl on patients with controlled intravenous analgesia

Objective To compare the efficacy of sufentanil and fentanyl on patients with conteolled intravenous analgesia postoperatively.Methods A total of 60 ASA Ⅰ-Ⅱpatients underwent elective abdominal surgery were randomly divided into sufentanil group and fentanyl group（n=30 for each group）.The loading dose for patient controlled intravenous analgesia（PCIA） in both groups was fentanyl 0.02 mg and droperidol 1.5mg.Postoperative analgesia was obtained by a patient-controlled intravenous pump.Patients in the sufentanil group were received sufentanil 0.1mg with sodium chloride injection 100ml,and patients in the fentanyl group were received fentanyl 1.0mg with sodium chloride injection 100ml.The visual analog scale（VAS）,Ramsay scale,patient satisfaction and adverse reactions were investigated 48h after operation.Results VAS scores at 4,8h after operation in the sufentanil group were lower than those in the fentanyl group（all P＜0.05）.Ramsay scale scores in the sufentanil group were higher than those in the fentanyl group（all P＜0.05）.There were no significant differences in PCIA pressing times and adverse reactions between the two groups（all P＞0.05）.Conclusion Intravenous postoperative analgesia with sufentanil had better analgesic effect and stronger sedation effect than equivalent dose of fentanyl.