Jabalameli Mitra, Talakoub Reihanak, Abedi Bita, Ghofrani Zahra
Department of Anesthesiology, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2016 Dec 27;5:198. doi: 10.4103/2277-9175.190989. eCollection 2016.
The objective of this study was to evaluate and compare the effects of three methods of using intravenous (IV), subcutaneous and intranasal (IN) fentanyl for pain management following general anesthesia in patients undergoing cesarean section.
A prospective, randomized, single-blind clinical trial was done on 75 patients aged 20-40 years, American Society of Anesthesiology-1, who had a normal singleton pregnancy beyond 36 weeks of gestational age. Patients were randomized to receive 50 μg fentanyl intravenously (Group 1), subcutaneously (Group 2) or intranasally (Group 3) after closure of incision. The pain intensity, nausea, the systolic, and diastolic blood pressures were assessed.
All groups were equivalent for baseline characteristics. The average pain visual analog scale (VAS) score was less in the second group who received fentanyl subcutaneously at the time of recovery admission (6.8 ± 1.5) ( = 0.037) and after 3 h (6.36 ± 1.5) ( = 0.033) postoperatively. The mean VAS score of nausea and the mean systolic and diastolic blood pressures were not significantly different between three groups throughout the study ( > 0.05).
subcutaneous fentanyl is an effective alternative to IV and IN route of administration for pain management.
本研究的目的是评估和比较剖宫产患者全身麻醉后静脉注射、皮下注射和鼻内给予三种芬太尼给药方法对疼痛管理的效果。
对75例年龄在20 - 40岁、美国麻醉医师协会分级为1级、孕龄超过36周的单胎妊娠正常孕妇进行了一项前瞻性、随机、单盲临床试验。患者在切口缝合后随机接受静脉注射50μg芬太尼（第1组）、皮下注射（第2组）或鼻内给予（第3组）。评估疼痛强度、恶心程度、收缩压和舒张压。
所有组的基线特征相当。在恢复入院时，皮下注射芬太尼的第2组平均疼痛视觉模拟量表（VAS）评分较低（6.8±1.5）（P = 0.037），术后3小时也较低（6.36±1.5）（P = 0.033）。在整个研究过程中，三组之间恶心的平均VAS评分以及平均收缩压和舒张压没有显著差异（P>0.05）。
皮下注射芬太尼是静脉注射和鼻内给药途径用于疼痛管理的有效替代方法。
