舒芬太尼应用于非体外循环冠状动脉旁路移植术后镇痛效果的研究

目的:评价舒芬太尼应用于非体外循环冠状动脉旁路移植术(OPCABG)后镇痛的效果。方法:选择行OPCABG术患者130例,随机分成2组,试验组:舒芬太尼(Sufentanil)镇痛组(A组,n=65例)和对照组:地佐辛(Dezocin)镇痛组(B组,n=65例)。A组静脉持续输注舒芬太尼镇痛液2 mL/h,2.5μg/mL,B组持续静脉输注地佐辛镇痛液2 mL/h,25μg/mL。观察指标:疼痛评分:术后16 h、24 h、48 h、拔除镇痛泵后12 h,采用视觉模拟评分法(VAS)进行镇痛效果评分、镇静效果评分(Ramsay)。结果:1.手术后VAS法评分:2组都在4分以下,差异无统计学意义(P>0.05)。2.手术后2组患者的镇静评分(Ramsay评分):差异无统计学意义(P>0.05)。拔泵以后舒芬组有5例轻微躁动,地佐辛组有3例,但差异无统计学意义(P>0.05)。3.2组患者PCA次数在手术后16 h:地佐辛组比舒芬太尼组多,差异有统计学意义(P<0.05)。4.镇痛期间不良反应:2组患者恶心、呕吐、尿储留的发生率差异无统计学意义(P>0.05),A组中有17例患者有眩晕,B组中有9例,差异有统计学意义(P<0.05)。结论:舒芬太尼用于OPCABG患者术后镇痛效果优于地佐辛,其恶心、呕吐、尿潴留的发生率差异无统计学意义,但患者术后眩晕的发生率舒芬太尼高于地佐辛。

Effects of sufentanil on postoperative pain control for patients undergoing off - pump coronary artery bypass surgery

Objective:To evaluate the effects of sufentanil on postoperative pain control for patients undergoing off-pump coronary artery bypass grafting surgery.Methods:130 patients undergoing elective off-pump coronary artery bypass grafting were randomly divided into two groups(Group A and Group B): patients in group A received intravenous infusion of sufentanil for postoperative analgesia from the end of the operation(containing sufentanil 2.5 μg/mL,infusion rate=2.5 mL/h,n=65),while group B received intravenous infusion of dezocin(infusion rate=2.5 mL/h,containing dezocin 25μg/mL,n=65).The Visual analog scale(VAS) and ramsay sedation scores(RSS) were measured at 16h,24h,48h postoperatively and 16h after the remove of patient-controlled analgesia(PCA) device respectively.The adverse reactions of analgesia were recorded.Results:Patients in the two groups achieved satisfied analgesia postoperatively with the VAS value all below 4.There were no difference in VAS value and the RSS value between the two groups(P>0.05 respectively).The total number of PCA pressing were higher in group B than that of group A at 16h after remove of the PCA device.The occurrence of postoperative nausea,vomiting and urinal retention showed no difference in two groups.Patient in group B experienced more dizziness when compared with group A(P<0.05).Conclusion:Sufentanil showed better effect of postoperative pain control in patients after off-pump coronary bypass grafting with less dizziness and similar occurrence rate of postoperative nausea,vomiting and urinal retention comparing with dezocin.