舒芬太尼静脉自控镇痛在骨科脊柱手术后的应用观察

目的观察舒芬太尼在骨科脊柱全麻手术后静脉自控镇痛的效果、安全性和不良反应。方法选择行择期脊柱全麻手术病例60例,ASA分级均为Ⅰ-Ⅱ级,随机分成两组,术后行静脉自控镇痛。A组术后镇痛采用芬太尼1 mg＋托烷司琼2 mg＋生理盐水共100 ml。B组术后镇痛采用舒芬太尼150μg＋托烷司琼2 mg＋生理盐水共100 ml。A组负荷量为芬太尼50μg＋托烷司琼2 mg,B组负荷量为舒芬太尼5μg＋托烷司琼2 mg。两组背景剂量为2 ml/h,单次给药0.2 ml/次,锁定时间为15 min。观察全麻术后镇痛2h、4 h、8 h、24 h、48 h的VAS评分、镇静评分和恶心呕吐、皮肤瘙痒、呼吸抑制等不良反应。结果B组术后2 h、4 h、8 h、24 h、48 h的VAS评分、镇静评分均优于A组（P〈0.05）。两组恶心呕吐、皮肤瘙痒等不良反应都比较低,两组差异无统计学意义（P〉0.05）。结论舒芬太尼用于脊柱手术后静脉自控镇痛疗效确切、安全可靠、不良反应少,值得在临床上推广。

Postoperative patients-controlled intravenous analgesia with sufentanil in patients underwent vertebral operation

Objective To observe the analgesic effect, safety and side effect of postoperative patients - controlled intravenous analgesia with sufentanil in patients underwent vertebral operation. Methods Sixty patients （ASA I - II ） underwent elective general anesthesia were randomly divided into two groups on postoperative patients -controlled intravenous analgesia. Groups A （n =30） ： fentanyl 1 mg ＋ tropistron 2 mg ＋ sodium chloride to 100 ml. Groups B （ n = 30） ： sufentanil 150μg ＋ tropistron 2 mg ＋ sodium chloride to 100 ml. Groups A loading was fentanyl 50μg and tropistron 2 rag, Groups B loading was sufentanil 5μg and tropistron 2 mg. The two groups background dose 2 ml/h, controlled dose 0.2 ml/time and lock time 15 minutes. The postoperative analgesic visual analogue scale and sedation scale at 2, 4 , 8, 24 and 48 h were recorded. The side effects of postoperative analgesic were recorded. Results The postoperative analgesic visual analogue scale and sedation scale at 2, 4 , 8, 24 and 48 h in Groups B were better than those in Groups A （ P 〈0.05 ）. The side effects of two groups were little and similar. Conclusion Sufentanil could be safely and effectively used in patients - controlled intravenous analgesia after vertebral surgery with little side effects, and hence worth being spread.