舒芬太尼与芬太尼用于老年全髋置换术后镇痛的效果比较

目的 探讨舒芬太尼用于老年全髋置换术后疼痛的临床效果.方法 选择2010年1月至2012年12月实施老年全髋置换术患者400例,随机分为两组,各200例,有387例在椎管内麻醉下完成手术,13例在气管插管全身麻醉下完成手术,镇痛泵负荷剂量舒芬太尼组为3 μg舒芬太尼,芬太尼组为0.03 mg芬太尼,其中舒芬太尼组使用术后自控静脉镇痛由100 μg舒芬太尼＋10 mg托烷司琼＋生理盐水配置成96 ml静脉泵入,芬太尼组则使用1.0 mg芬太尼＋10 mg托烷司琼＋生理盐水配置成96 ml静脉泵入,两组单次给药剂量均为0.5 ml,锁定时间为15 min,连续输注剂量为2 ml/h,比较两组不良反应和静息、运动视觉模拟评分法（VAS）评分.结果 舒芬太尼组恶心、呕吐及皮肤瘙痒的比率均显著低于芬太尼组（P＜0.01）,舒芬太尼组患者静息VAS评分和运动VAS评分均显著低于芬太尼组（P＜0.01）.结论 舒芬太尼用于老年全髋置换术后静脉镇痛,其效果显著,不良反应少,值得临床推广.

Comparison of effects of sufentanil and fentanyl for alleviating pains caused by total hip arthroplasty for elderly patients

Objective To investigate the effects of sufentanil and fentanyl for alleviating pains caused by total hip arthroplasty for elderly patients.Methods 400 elderly patients who underwent total hip arthroplasty from Jan, 2010 to Dee,2012 were randomly divided into two groups, with 200 cases in each group.387 cases of them underwent the operation under spinal-epidural anesthesia and 13 cases under general anesthesia. The loading dose of analgesia pump in Sufentanil Group was 3 μg of sufentanil and that in the Fentanil Group is 0.03 mg of fentanil.For the self-controlled intravenous analgesia in the Sufentanil Group, 100 μg of sufentanil, 10 mg of tropisetron and physiological sa- line were configured into 96 ml of medicine for intravenous pumping.In the Sufentanil Group, 1.0 mg of fentanyl, 10 mg of tropisetron and 96 ml physiological saline were configured into 96 ml of medicine for intravenous pumping. Both groups were given 0.5 ml of medicine once for 15 mins and the continuous injected dose was 2 ml/h.Then,the adverse reactions and VAS scores of resting and exercise were compared between two groups.Results Rates of nausea,vomiting and pruritus in Sufentanyl Group were significantly lower than those in the Fentanyl Group（ P 〈0.01）.VAS scores of resting and exercise of the Sufentanil Group were significantly lower than those of the Fentanyl Group（ P 〈0.01）.Conelusion The effect of sufentanil for elderly intravenous analgesia for total hip replacement is significant and it has few adverse reactions.Thus,it is worthy of clinical promotion.