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舒芬太尼与芬太尼静脉患者自控镇痛对腹腔镜肾切除术后恶心呕吐的比较:一项前瞻性、双盲、随机对照试验。

Comparison of Sufentanil- and Fentanyl-based Intravenous Patient-controlled Analgesia on Postoperative Nausea and Vomiting after Laparoscopic Nephrectomy: A Prospective, Double-blind, Randomized-controlled Trial.

机构信息

Department of Anesthesiology and Pain Medicine, and Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.

出版信息

Int J Med Sci. 2020 Jan 14;17(2):207-213. doi: 10.7150/ijms.39374. eCollection 2020.

Abstract

: The incidence of postoperative nausea and vomiting (PONV) remains high. The effects of sufentanil for PONV is not firmly confirmed. The aim of this study was to compare the effect of sufentanil- and fentanyl-based intravenous patient-controlled analgesia (IV-PCA) on the incidence of PONV after laparoscopic nephrectomy. : Eighty-six patients were randomly allocated to receive either the sufentanil (n =43) or fentanyl (n =43). IV-PCA was prepared using either sufentanil 3 µg/kg or fentanyl 20 µg/kg, ramosetron 0.3 mg, and ketorolac 120 mg. The primary outcome of was the incidence of PONV during 24 h after post anesthesia care unit (PACU) discharge. The secondary outcomes were the modified Rhodes index and patient satisfaction scores at 24 h after PACU discharge, need for rescue antiemetics, pain score, need for additional analgesics, and cumulative consumption of IV-PCA : The incidence of PONV was comparable between the sufentanil and fentanyl groups (64.3% vs. 65%, p = 0.946; respectively). The number of patients who required antiemetics (p = 0.946) and the modified Rhodes index at 24 h after post-anesthesia care unit discharge (p = 0.668) were also comparable in both groups. No significant differences were found in the secondary outcomes, including the analgesic profiles and adverse events between the groups. : In conclusion, sufentanil- and fentanyl-based IV-PCA showed similar incidence of PONV with comparable analgesic effects after laparoscopic nephrectomy. Based on these results, we suggest that sufentanil and fentanyl may provide comparable effects for IV-PCA after laparoscopic nephrectomy.

摘要

术后恶心呕吐(PONV)的发生率仍然很高。舒芬太尼预防 PONV 的效果尚未得到明确证实。本研究旨在比较舒芬太尼和芬太尼静脉患者自控镇痛(IV-PCA)对腹腔镜肾切除术后 PONV 发生率的影响。

86 例患者随机分为舒芬太尼组(n=43)或芬太尼组(n=43)。IV-PCA 采用舒芬太尼 3μg/kg 或芬太尼 20μg/kg、雷莫司琼 0.3mg 和酮咯酸 120mg 配制。主要结局是 PACU 出院后 24 小时内 PONV 的发生率。次要结局是 PACU 出院后 24 小时改良 Rhodes 指数和患者满意度评分、需要解救止吐药、疼痛评分、需要额外镇痛药物以及 IV-PCA 的累积消耗量。

PONV 的发生率在舒芬太尼组和芬太尼组之间无差异(64.3%比 65%,p=0.946)。需要止吐药的患者人数(p=0.946)和 PACU 出院后 24 小时改良 Rhodes 指数(p=0.668)在两组之间也相似。两组间的次要结局,包括镇痛效果和不良反应,均无显著差异。

总之,舒芬太尼和芬太尼基础 IV-PCA 在腹腔镜肾切除术后 PONV 发生率相似,且镇痛效果相当。基于这些结果,我们建议舒芬太尼和芬太尼可能为腹腔镜肾切除术后 IV-PCA 提供相似的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5b3/6990885/fa435765fcf7/ijmsv17p0207g001.jpg

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