关键词: 患者自控镇痛, 神经外科, 舒芬太尼, 皮下注射

Abstract: Objective To evaluate the efficacy and safety of sufentanil used for patient-controlled subcutaneous analgesia (PCSA) with different models after craniotomy.Methods Sixty ASA Ⅰ～Ⅱ patients undergoing craniotomy were randomly divided into two groups with or without background infusion. Sufentanil 0.12 mg was used via patient-controlled analgesia (PCA) and no loading dose was administered. The PCA device was programmed background infusion of 1 ml/h, bolus dose of 0.5 ml in group of using continuance plus PCA model (group CP) and bolus dose of 0.75 ml without background infusion in group P. Hour limit of 3 ml/h, lockout time of 15 minutes were set in two groups. Postoperative pain was assessed at rest and when moving, using Visual Analogue Scale (VAS) at 2 h, 20 h, 24 h, 44 h and 48 h after operation. Side-effects were also recorded systematically during the first 48 h after surgery.Results No significant differences were observed in patients' physical status, fentanyl consumption during operation and anaesthetic time. There were no significant differences in VAS scores between the two groups within 48 h after operation, but the incidence of complaining postoperative pain was significantly more in group P than that in group CP at 20 h and 24 h after surgery (P<0.05). The cumulative analgesic consumption of sufentanil in group CP and group P were 98.73±5.96 μg and 57.25±9.73 μg, respectively (P<0.05). Compared with group P, the mean arterial pressure in 20 h and 24 h were significantly lower in group CP (P<0.05). The sedation degree and the incidence of nausea, vomiting in two groups had no significant differences. No restrain of respiration occurred in two groups. The patients' satisfactory rate with PCA in group CP and group P were 90% and 80%, respectively.Conclusion PCSA with sufentanil and continuance plus PCA model is an effective and safe analgesic method after craniotomy.

Key words: patient-controlled analgesia, neurosurgery, sufentanil, subcutaneous injection