【摘要】 目的 觀察不同劑量的舒芬太尼用于剖宮產術后硬膜外自控鎮痛的效果比較。 方法 將2009年4-11月60例硬膜外麻醉下行剖宮產手術術后的患者隨機分為三組，術后鎮痛液A組采用0.125%羅哌卡因復合0.3 μg/mL舒芬太尼；B組為0.125%羅哌卡因復合0.4 μg/mL舒芬太尼；C組0.125%羅哌卡因復合0.5 μg/mL舒芬太尼，觀察三組患者的術后鎮痛效果（視覺模擬法評分，即VAS評分）及不良反應。 結果 A組VAS評分高于B組和C組，B組VAS評分高于C組（Plt;0.05）。三組患者術后惡心嘔吐、運動阻滯、嗜睡及腸蠕動抑制等并發癥無統計學差異（Pgt;0.05）。 結論 0.125%羅哌卡因復合0.5 μg/mL舒芬太尼以4 mL/h持續輸注用于剖宮產術后患者自控硬膜外鎮痛術后疼痛VAS評分最小，患者鎮痛滿意度最高。【Abstract】 Objective To observe the effect of postoperative patient-controlled epidural analgesia (PCEA) with three different doses of sufentanil combined with 0.125% ropivacaine after cesarean section. Methods Data was collected from April 2009 to November 2009. Sixty patients after cesarean section under continuous epidural anesthesia were randomly divided into three different groups.Group A was given sufentanil 0.3 μg/mL and 0.125% ropivacaine for PCEA, group B was given sufentanil 0.4 μg/mL and 0.125% ropivacaine, group C was given sufentanil 0.5 μg/mL and 0.125% ropivacaine. The analgesia effects were evaluated by the visual analogue scales (VAS). Side effects were also recorded. Results The VAS scores were significantly the highest in group A than that in group B and group C, the VAS scores in group B were higher than that in group C (Plt;0.05). The incidence of side effects, such as postoperative nausea and vomiting, lethargy, and pruritus, was not significant among the three groups (Pgt;0.05). Conclusion 0.5 μg/ mL sufentanil and 0.125% ropivacaine recommended for PCEA with background 4 mL/h is safe and effective for patients after cesarean section.
【摘要】目的觀察低濃度羅哌卡因復合舒芬太尼用于分娩鎮痛的效果。方法2007年5月8月按入選標準選擇100例產婦,隨機分成試驗組和對照組,每組50例。試驗組分娩前給予低濃度羅哌卡因加舒芬太尼,對照組不行無痛分娩,通過視覺模擬評分法等指標觀察鎮痛效果。結果試驗組鎮痛后視覺模擬評分較對照組低(Plt;0.05);兩組鎮痛期間血壓、心率差異有統計學意義（Plt;0.05），新生兒Apgar評分比較無統計學意義(Pgt;0.05)。結論聯合應用羅哌卡因和舒芬太尼用于硬膜外分娩鎮痛能取得較好的效果,值得在臨床中推廣應用。
目的 評價舒芬太尼復合艾司洛爾對腹腔鏡膽囊切除術二氧化碳氣腹期間心血管反應和腦電雙頻指數（BIS）的影響。 方法 2010年1月－2011年12月間，選擇美國麻醉醫師協會分級Ⅰ～Ⅱ級擇期腹腔鏡膽囊切除術患者90例，隨機分為芬太尼組（A組）、舒芬太尼組(B組）和舒芬太尼+艾司洛爾組（C組）。A組用芬太尼4 μg/kg，B、C組用舒芬太尼0.6 μg/kg麻醉誘導后氣管插管，機械通氣；C組在氣腹前加用艾司洛爾。3組均常規靜脈注射咪達唑侖0.1 mg/kg、丙泊酚2 mg/kg和維庫溴銨0.1 mg/kg。分別記錄各組在氣腹前（T1）、氣腹30 s（T2）、氣腹5 min（T3）、氣腹15 min（T4）時的收縮壓、舒張壓、平均動脈壓、心率、血氧飽和度和BIS值。 結果 T1時C組收縮壓、舒張壓、心率、BIS值最低，各組間差異無統計學意義（P＞0.05）；T2、T3、T4時A組收縮壓、舒張壓、心率、BIS明顯增加，B組有所上升，ⅢC組各時段變化不明顯。A組與B組、B組與C組間差異有統計學意義（P＜0.05）。 結論 舒芬太尼復合艾司洛爾能更好地預防腹腔鏡膽囊切除術二氧化碳氣腹期間心血管反應和抑制BIS的增加。
Objective To investigate clinical application and safety evaluation of sedative demulcent anesthesia in therapeutic endoscopic retrograde cholangiopancreatography (ERCP).Methods Totally 1660 patients underwent ERCP at the First Hospital of Lanzhou University were prospectively divided into two groups: venous sedative demulcent group (n=800, using sufentanil and midazolam and propofol continuing infusion) and conventional sedative demulcent group (n=860, using common medicine). The heart rate (HR), respiration (R), blood pressure (BP) and peripheral oxygen saturation (SpO2) of pre-anesthesia, post-anesthesia, during operation and after analepsia in every group were detected. The narcotism was evaluated by Ramsaymin grading method and the related adverse reactions such as cough, restlessness, harmful memory, and abdominal pain after operation were recorded. Results Compared with conventional sedative demulcent group, vital signs of patients in venous sedative demulcent group were more stable. For postoperative adverse reactions, abdominal pain, abdominal distension and nausea and vomiting were respectively 4.4%(35/800), 2.6%(21/800) and 3.6%(29/800) in venous sedative demulcent group, which were respectively higher of the incidence of 36.3%(312/860), 49.0%(421/860) and 53.0%(456/860) in conventional sedative demulcent group (P＜0.01). The postoperative satisfaction and adverse reactions recall between venous sedative demulcent group and conventional sedative demulcent group was respectively significant different (96.9% vs. 2.9%, 4.8% vs. 97.9%, P＜0.01). Conclusion Sufentanil and midazolam and propofol continuing infusion have good effect of sedative demulcent anesthesia, which can be widely used.
【摘要】 目的 比較舒芬太尼與等效劑量芬太尼在髖關節置換術后患者硬膜外鎮痛的臨床效果。 方法 2006年11月-2008年9月收治的50例硬膜外麻醉下髖關節置換術患者，隨機分為兩組（n=25）。芬太尼組（A組）:芬太尼0.75 mg加0.894%甲磺酸哌卡因20 mL加生理鹽水至100 mL；舒芬太尼組（B組），舒芬太尼75 μg加0.894%甲磺酸哌卡因20 mL加生理鹽水至100 mL硬膜外鎮痛。其中，A組患者于手術結束時，靜脈滴注格拉司瓊3 mg。持續劑量2 mL/h，單次給藥量（PCA）0.5 mL/次，鎖定時間15 min。觀察兩組的鎮痛效果，惡心、嘔吐次數，記錄脈搏血氧飽和度、心率、呼吸的變化。 結果 鎮痛泵開機后，B組各時段鎮靜評分，2分以上者明顯多于A組，鎮痛評分明顯低于A組，有統計學意義（Plt;0.05），兩組術后惡心、嘔吐發生率都較低，組間差異無統計學意義（Pgt;0.05）。兩組4、12、24 h的呼吸頻率和脈搏血氧飽和度差異有統計學意義（Plt;0.05），但48 h的呼吸頻率和脈搏血氧飽和度無統計學意義（Pgt;0.05）。 結論 在等效劑量下，髖關節置換術后患者硬膜外鎮痛，舒芬太尼明顯優于芬太尼。【Abstract】 Objective To compare the clinical effect of epidural analgesia with sufentanil and fentanyl in an equivalent dose after hip replacement. Methods From December 2006 to September 2008, fifty cases of epidural anesthesia after hip replacement were randomly divided into two groups, each group had 25 cases. Group A (fentanyl group): fentanyl mesylate 0.75 mg+0.894% ropivacaine 20 mL+0.9% sodium chloride solution to 100 mL; group B (sufentanil group): sufentanil 75 μg+0.894% ropivacaine mesylate 20 mL+0.9% sodium chloride solution to 100 mL epidural analgesia. Patients in group A received intravenous infusion of granisetron 3 mg at the end of surgery. Continuous dose was 2 mL/h, with the volume of single dose (PCA) 0.5 mL per time and lockout time of 15 minutes. The analgesic effect, nausea, and vomiting frequency were observed, and the pulse oxygen saturation, heart rate, and breathing changes were recorded. Results After boot analgesia, S sedation scores for each phase and pain score in group B were significantly different compared with those in group A (Plt;0.05). Both groups had low incidence of nausea and vomiting, and the difference was not statistically significant (Pgt;0.05). The difference of respiratory rate and pulse oxygen saturation at 4 h, 12 h, 24 h was statistically significant between two groups (Plt;0.05), but at 48 h the difference was not significant (Pgt;0.05). Conclusion In the equivalent dose, epidural analgesia with sufentanil in the patients with hip replacement is superior to fentanyl.
Objective To assess the safety and efficacy of sufentanil combined with propofol for painless fiberbronchoscopy. Methods A total of 120 patients undergoing fiberbronchoscopy were divided into two groups according to their admission sequence: group S (sufentanil + propofol, n=60) and group F (fentanil + propofol, n=60). Parameters including heart rate (HR), systol ic blood pressure (SBP), diastol ic blood pressure (DBP), saturation of blood oxygen (SPO2), dose of propofol, duration of the procedure, waking time and score of Observer’s Assessment of Alertness/Sedation (OAA/S) scale were recorded. Results The HR increased significantly 3 minutes after drug administration in both groups (Plt;0.05). The SPO2 decreased significantly 3 minutes after drug administration in both groups (Plt;0.05). The average dose of propofol and OAA/a score were similar between the two groups (Pgt;0.05). The waking time was significantly shorter in group S than in group F (Plt;0.05). Conclusion Sufentanil combined with propofol could offer a good sedative/analgesic effect during painless fiberbronchoscopy.
ObjectivesTo systematically evaluate the efficacy and safety of dezocine combine with sufentanil (DS) versus sufentanil (S) for postoperative analgesia.MethodsCNKI, WanFang Data, VIP, PubMed, Wiley Online Library and ScienceDirect databases were searched online to collect randomized controlled trials (RCTs) of DS versus S for postoperative analgesia from January 2011 to July 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using Stata13.0 software.ResultsA total of 39 RCTs were included. The results of meta-analysis showed that: DS group had higher scores on VAS at 2 h, 6 h, 12 h, 24 h and 48 h points than S group at the dezocine level of 0.2 mg/kg. At the dezocine level of 0.3 mg/kg, there were no significant differences in scores on VAS at 2 h and 4 h. However, DS group had higher scores at 6 h, 12 h, 24 h and 48 h points. At the dezocine level of 10 mg/kg, there were no significant differences in scores on VAS at each time point in both groups. DS group was superior to S group in " excellent rate” and " good rate” of the analgesic satisfaction of patients. For safety, the incidence of postoperative nausea and vomiting of DS group was lower than S group.ConclusionsThe current evidence shows that dezocine combine with sufentanil have more effects of postoperative analgesia than sufentanil alone, and its incidence of adverse reactions is lower. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusions.
目的:比較舒芬太尼與芬太尼復合七氟烷麻醉在神經外科手術中對血流動力學、拔管時間、蘇醒時間及術后疼痛情況的影響。方法:擇期開顱手術患者60例,隨機分為舒芬太尼(S)組和芬太尼(F)組,每組30例。將S和F的效能比定為10:l,復合咪唑安定、維庫溴胺、異丙酚來進行麻醉誘導;麻醉維持均復合七氟烷。分別記錄麻醉前、誘導后、插管時和拔管時血壓和心率變化;呼吸恢復、睜眼和拔管時間以及拔管后半小時疼痛評分(VAS評分)。結果:兩組麻醉誘導后收縮壓(SBP)、舒張壓(DBP)、心率(HR)均較誘導前有顯著性下降(Plt;0．05)。F組插管及拔管時,血流動力學變化均較S組有顯著性升高(Plt;0.05)。S組蘇醒期呼吸恢復、睜眼、拔管時間較F組明顯縮短;拔管后半小時疼痛評分(VAS評分)S組低于F組。結論:與芬太尼相比,等效劑量的舒芬太尼用于腦外科手術患者麻醉誘導可更有效地減輕全麻誘導氣管插管時的心血管反應;在麻醉蘇醒期,更有利于呼吸管理及術后鎮痛。舒芬太尼在神經外科麻醉中具有很好的臨床應用價值。
ObjectivesTo systematically review the efficacy and safety of sufentanil versus fentanyl used in patient-controlled intravenous analgesia (PCIA) after cesarean section.MethodsAn online search of computerized searches of the database of MEDLINE (OVID), Web of Science, The Cochrane Central Register of Controlled Trials, PubMed, EMbase, CNKI, WanFang Data, VIP and SinoMed were conducted. Randomized controlled trials published since the inceptions of these databases until April 1st 2018, involving the comparison of sufentanil versus fentanyl for PCIA after cesarean section were included. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was conducted using the RevMan 5.1 software.ResultsA total of 19 studies were included. The results of meta-analysis showed that, compared with the fentanyl group, the sufentanil group had statistically significant lower VAS scores at 4-hour (MD=–0.99, 95%CI –1.03 to –0.95, P<0.001), 8-hour (MD=–0.30, 95%CI –0.40 to –0.21, P<0.001), 12-hour (MD=–0.54, 95%CI –0.62 to –0.46, P<0.001) and 24-hour (MD=–0.35, 95%CI –0.41 to –0.28, P<0.001); statistically significant higher Ramsay scores at 4-hour (MD=0.72, 95%CI 0.66 to 0.78, P<0.001), 8-hour (MD=0.93, 95%CI 0.86 to 1.00, P<0.001), 12-hour (MD=0.98, 95%CI 0.91 to 1.05, P<0.001), 24-hour (MD=0.07, 95%CI 0.03 to 0.11, P=0.000 5), 48-hour (MD=0.05, 95%CI 0.03 to 0.08, P<0.000 1). As for the adverse reactions, sufentanil group had lower risks of having nausea and vomiting (RR=0.25, 95%CI 0.19 to 0.31, P<0.001), pruritus (RR=0.41, 95%CI 0.30 to 0.57, P<0.001), dizziness (RR=0.27, 95%CI 0.17 to 0.44, P<0.001) and urinary retention (RR=0.35, 95%CI (0.15, 0.82), P=0.02).ConclusionsThe current evidence shows that, sufentanil has better analgesia and sedative effects, and less risks of adverse reactions for safer clinical use.