舒芬太尼与芬太尼应用于术后患者自控静脉镇痛的比较

目的比较等效剂量舒芬太尼与芬太尼用于术后患者自控镇痛的临床效应。方法 40例ASAⅠ～Ⅱ级择期腹部手术患者随机分为2组,每组20例。2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),舒芬太尼与芬太尼组分别给予舒芬太尼0.1 mg和芬太尼1.0 mg,以氯化钠注射液稀释至100 mL,静脉泵入。观察术后48 h内2组VAS评分、镇静评分,患者满意度以及不良反应。结果舒芬太尼组术后4、8 h的VAS评分为(2.7±1.5)、(2.3±1.0),低于芬太尼组(3.4±1.6、3.1±1.1,P<0.05);镇静评分为(2.4±0.5)、(2.3±0.6),高于芬太尼组(1.2±0.6、1.1±0.5,P<0.05)。2组患者PCIA按压次数、总体满意度、不良反应发生率无显著差异(P>0.05)。结论舒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 vs.fentanyl on patients with controlled intravenous analgesia

AIM To compare the efficacy of sufentanil and fentanyl on patients with controlled intravenous analgesia postoperatively.METHODS A total of 40 ASA Ⅰ-Ⅱ patients undergoing elective abdominal surgery were randomly divided into sufentanil group and fentanyl group(n = 20 for each group).The loading dose for patient controlled intravenous analgesia(PCIA)in both groups was fentanyl 0.02 mg and droperidol 1.5 mg.Postoperative analgesia was obtained by a patient-controlled intravenous pump.Patients in the sufentanil group were received sufentanil 0.1 mg with sodium chloride injection 100 mL,and patients in the fentanyl group were received buprenorphine 1.0 mg with sodium chloride injection 100 mL.The visual analog scale(VAS),Ramsay scale,patient satisfaction and adverse reactions were investigated at 4,8 h after operation.RESULTS VAS scores at 4,8 h after operation in the sufentanil group(2.7 ± 1.5 and 2.3 ± 1.0)were lower than those in the fentanyl group(3.4 ± 1.6 and 3.1 ± 1.1,P < 0.05).Ramsay scale scores in the sufentanil group(2.4 ± 0.5 and 2.3 ± 0.6)were higher than those in the fentanyl group(1.2 ± 0.6 and 1.1 ± 0.5,P < 0.05).There were no significant differences in PCIA pressing times,patient satisfaction and adverse reactions between the two groups(P > 0.05).CONCLUSION Intravenous postoperative analgesia with sufentanil has better analgesic effect and stronger sedation effect than equivalent dose of fentanyl.