Checketts M R, Gilhooly C J, Kenny G N
Glasgow University Department of Anaesthesia, Health Care International, Clydebank.
Br J Anaesth. 1998 Jun;80(6):748-51. doi: 10.1093/bja/80.6.748.
The performance of a patient-demand, target-controlled alfentanil infusion system was compared with that of a traditional morphine patient-controlled analgesia (PCA) pump in 120 adult patients after cardiac surgery. Patients were randomized to one of the two PCA systems for their postoperative analgesia in the intensive care unit and pain, nausea and sedation scores were recorded every 4 h for the first 24 h. Episodes of hypoxaemia, myocardial ischaemia and haemodynamic instability were also recorded. In patients using the alfentanil system the overall median visual analogue pain score was 2.3 (95% Cl 2.3-2.8) compared with 3.0 (95% Cl 2.7-3.2) in those using morphine PCA (P < 0.05), but both systems delivered high-quality analgesia. The two groups did not differ with respect to the overall sedation scores, the frequency of postoperative nausea and vomiting, haemodynamic instability, myocardial ischaemia or hypoxaemia.
在120例心脏手术后的成年患者中，对一种按需给药、靶控输注阿芬太尼的系统与传统吗啡患者自控镇痛（PCA）泵的性能进行了比较。患者被随机分为两种PCA系统中的一种，用于在重症监护病房进行术后镇痛，并在前24小时内每4小时记录一次疼痛、恶心和镇静评分。还记录了低氧血症、心肌缺血和血流动力学不稳定的发作情况。使用阿芬太尼系统的患者总体视觉模拟疼痛评分中位数为2.3（95%可信区间2.3 - 2.8），而使用吗啡PCA的患者为3.0（95%可信区间2.7 - 3.2）（P < 0.05），但两种系统均提供了高质量的镇痛效果。两组在总体镇静评分、术后恶心呕吐频率、血流动力学不稳定、心肌缺血或低氧血症方面无差异。
