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鞘内注射舒芬太尼与芬太尼用于下肢手术的随机对照试验

Intrathecal sufentanil versus fentanyl for lower limb surgeries - a randomized controlled trial.

作者信息

Motiani Poonam, Chaudhary Sujata, Bahl Nitin, Sethi A K

机构信息

Assistant Professor, Department of Anaesthesiology and Critical Care, Delhi State Cancer Institute, Dilshad Garden, Delhi - 110095.

出版信息

J Anaesthesiol Clin Pharmacol. 2011 Jan;27(1):67-73.

PMID:21804710
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3146162/
Abstract

BACKGROUND

To compare the efficacy and safety of intrathecal sufentanil or fentanyl as adjuvants to hyperbaric bupivacaine in patients undergoing major orthopaedic lower limb surgeries in terms of onset and duration of sensory block, motor block and post-operative pain relief. PATIENTS #ENTITYSTARTX00026;

METHODS

Ninety patients were recruited in this Prospective, randomized double blind study to receive either intrathecal sufentanil 5 μg (Group S), fentanyl 25 μg (Group F) or normal saline 0.5 ml (Group C) as adjuvants to 15 mg of 0.5% hyperbaric bupivacaine. The onset and duration of sensory and motor block were assessed intraoperatively. The pain scores were assessed postoperatively. Duration of complete and effective analgesia was recorded. The incidence of side effects such as nausea, vomiting, pruritus, shivering and PDPH was recorded.

RESULTS

The Demographic data, hemodynamic and respiratory parameters were comparable in the three groups. There was a significantly earlier onset and prolonged duration of sensory block in the sufentanil and fentanyl groups. The duration of complete and effective analgesia were also significantly prolonged in the fentanyl and sufentanil groups. Pruritus was noticed in the study groups (Groups S&F).

CONCLUSIONS

Intrathecal sufentanil (5 μg) and fentanyl (25 μg), as adjuvants lead to an earlier onset and prolonged duration of sensory block. The duration of effective analgesia with intrathecal sufentanil and fentanyl as adjuvants to hyperbaric bupivacaine is longer than that of bupivacaine alone.

摘要

背景

比较鞘内注射舒芬太尼或芬太尼作为辅助药物与高压布比卡因联合用于下肢骨科大手术患者时,感觉阻滞、运动阻滞的起效时间和持续时间以及术后疼痛缓解情况的疗效和安全性。患者……

方法

本前瞻性随机双盲研究招募了90例患者,分别接受鞘内注射5μg舒芬太尼(S组)、25μg芬太尼(F组)或0.5ml生理盐水(C组),作为15mg 0.5%高压布比卡因的辅助药物。术中评估感觉和运动阻滞的起效时间和持续时间。术后评估疼痛评分。记录完全有效镇痛的持续时间。记录恶心、呕吐、瘙痒、寒战和腰麻后头痛等副作用的发生率。

结果

三组患者的人口统计学数据、血流动力学和呼吸参数具有可比性。舒芬太尼组和芬太尼组感觉阻滞的起效明显更早,持续时间更长。芬太尼组和舒芬太尼组完全有效镇痛的持续时间也显著延长。研究组(S组和F组)出现了瘙痒。

结论

鞘内注射舒芬太尼(5μg)和芬太尼(25μg)作为辅助药物可使感觉阻滞起效更早、持续时间更长。鞘内注射舒芬太尼和芬太尼作为高压布比卡因的辅助药物时,有效镇痛的持续时间比单独使用布比卡因更长。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3bf9/3146162/6410909cb8c4/JOACP-27-67-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3bf9/3146162/bf6a3e333375/JOACP-27-67-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3bf9/3146162/fd1d31f64aa0/JOACP-27-67-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3bf9/3146162/299e258114d2/JOACP-27-67-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3bf9/3146162/4ef62f8d6438/JOACP-27-67-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3bf9/3146162/abb2b2420e14/JOACP-27-67-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3bf9/3146162/6410909cb8c4/JOACP-27-67-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3bf9/3146162/bf6a3e333375/JOACP-27-67-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3bf9/3146162/fd1d31f64aa0/JOACP-27-67-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3bf9/3146162/299e258114d2/JOACP-27-67-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3bf9/3146162/4ef62f8d6438/JOACP-27-67-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3bf9/3146162/abb2b2420e14/JOACP-27-67-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3bf9/3146162/6410909cb8c4/JOACP-27-67-g007.jpg

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