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Background:Fentanylis a phenylpiperidine derivative synthetic opioid agonist. As an analgesic fentanyl is 75-125 times more potent than morphine. Sufentanil is a semisynthetic thienyl analogue fentanyl with analgesic potency 5 to 10 times more than that of fentanyl. Recently there has been an interest in using analgesics and localanaesthetics in an attempt to decrease the local anaestheticdose enabling fasterrecovery.Methods:A double blinded randomised study was carried out with 50 patients of ASA grade I and II aged between 20 and 60 years undergoing elective inguinal and below inguinalregionsurgeriesunder low dose spinal anaesthesia. Patientsreceived 10 mg of 0.5% hyperbaric bupivacaine with 50 μg of fentanyl added to a total volume of 3 ml(group F),and with sufentanil 5 μg [diluted with 5% dextrose] and volume made to 3 ml(group S). Postoperative VAS score for pain, duration of motor block and complications postoperatively is noted.Results:Prolonged postoperative analgesia was observed in group F (216.7min) and group S(264.8)which was statistically significant among the groups (p<0.001) is higher in group S and also duration of motor block in group F(130.6) and group S (90.5) which was statistically significant among the groups (p<0.001) which is higher in group F than group S. Conclusions: When compared to intrathecalbupivacaine-fentanyl combination; intrathecal bupivacaine-sufentanil combination provided prolonged postoperative analgesia with a lesser duration of motor blockade thus allowing early post operative ambulation
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Objective Increased pneumoperitoneum and intra-abdominal pressure during laparoscopic surgery may cause postoperative nausea and vomiting (PONV), avoiding the occurrence of which can accelerate postoperative recovery of the patients. In this study, we observed the effects of dexmedetomidine (DEX) on plasma motilin (MTL) and PONV in patients undergoing gynecologic laparoscopic surgery. Methods Eighty female patients underwent gynecological laparoscopic surgery under elective general anesthesia in our hospital from June 2017 to June 2018. We randomly assigned the patients to a control and a DEX group of equal number, the former injected intravenously with isotonic saline for 10 minutes at 40 minutes before the completion of surgery and the latter with DEX 0.5 μg/kg at 40 minutes before the end of and DEX 2.5 μg/kg + sufentanil 2.5 μg/kg after surgery. We compared the cough and sedation agitation scores (SAS) of the patients before and after extubation, the MTL concentration before and at 2, 24 and 48 hours after surgery, and the incidence and severity of PONV at 2, 24 and 48 hours postoperatively between the two groups. Results Compared with the controls, the patients of the DEX group showed significantly decreased cough and SAS scores before and after extubation (P < 0.05), MTL concentration at 2 hours ([478.81 ± 42.94] vs [391.39 ± 54.49] pg/mL, P < 0.05) and 24 hours after surgery ([385.64 ± 38.03] vs [321.96 ± 36.50] pg/mL, P < 0.05), and incidence rate of severe PONV at 2 hours (25.0% vs 5.0%, P < 0.05) and 24 hours postoperatively (20.0% vs 2.5%, P < 0.05). Intravenous pump injection of DEX at 0.5 µg/kg before the end of surgery can inhibit the postoperative release of MTL, effectively reduce the incidence and severity of PONV, and contribute to early recovery of the patients undergoing gynecologic laparoscopic surgery. Conclusion In gynecological laparoscopic surgery,0.5 µg/kg DEX used before the end of the surgery and low-dose maintenance of PCIA can inhibit the release of MTL after operation, effectively reduce the incidence and severity of PONV and improve the recovery quality of patients during anesthesia recovery period at the same time.
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Objective To discuss the efficacy of sufentanil combined with propofol in iv anesthesia during laparoscopic cholecystectomy.Methods Totally 182 patients received laparoscopic cholecystectomy.They were divided into two groups according to odd or even number of hospitalization.The control group (81 cases) were given remifentani combined with propofol for iv anesthesia.The observation group (101 cases) were given sufentanil combined with propofol for iv anesthesia.The anesthetic effect of sufentanil combined with propofol for iv anesthesia during laparoscopic cholecystectomy was evaluated by breathing recovery time,opening time,extubation time,VAS scores after 1,6,12 h,and complications during anesthesia.Results Breathing recovery time,opening time,and extubation time of observation group were longer than those of control group (P ＜ 0.05).The VAS scores after 1,6,and 12 h of observation group were lower than those of the control group (P ＜ 0.05).During anesthesia,the proportion of restlessness in observation group was lower than that in control group (P ＜ 0.05).The complication rate of observation group was lower than that of control group (P ＜ 0.05).Conclusion Sufentani combined with propofol has a good anesthetic effect on patients receiving laparoscopic cholecystectomy with mild postoperative pain and less restlessness.It is worthy of clinical use.
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Objective To invetigate the effect and safety of sufentanil mixed levobupivacaine on postoperative analgesia in pediatric caudal block anesthesia.Method Sixty pediatric patients (2 ～ 6 years old) who were undergoing elective abdominal surgery,such as repair hernia of high ligation,were randomly divided into three groups with 20 cases each.after intravenous induction,0.25％ levobupivacaine was injected in sacrum tube in group Ⅰ,0.5 μg/ml sufentanil mixed 0.25％ levobupivacaine and 1.0 μg/ml sufentanil mixed 0.25％ levobupivacaine were injected in sacrum tube in group Ⅱ and group Ⅲ respectively.The analgesia effect,the analgesia time,recover time and adverse reaction were observed and recorded 2,4,8,12,16,24 hours after the surgery.Results The analgesia effect in group Ⅱ、Ⅲ were significantly better than the group Ⅰ when 4、8、12 hours after the operation(P ＜0.05),and the analgesia effect in groupⅢ were significantly better than the group Ⅱ when 8 hours after the operation (P ＜ 0.05).There were no significant differences in three groups when 2、16、24 hours after the operation(P ＞0.05),the analgesia time in group Ⅱ、Ⅲ were significantly longer than the group Ⅰ (P ＜ 0.05),and the analgesia time in group Ⅲ were significantly longer than the group Ⅱ (P ＜ 0.05).There were no differences in the recovery time of three groups (P ＞ 0.05).There were no adverse reactions in three groups.Conclusions 0.5 μg/ml and 1.0 μg/ml sufentanil mixed 0.25％ levobupivacaine may be used on postoperative analgesia in pediatric caudal block anesthesia safely and analgesia effect and time were more better and longer than 0.25％ levobupivacaine singly.The analgesia effect in group with 1.0μg/ml sufentanil mixed 0.25％ levobupivacaine was the best in three groups with the fewest side effects.