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Abstract Background: Brachial plexus block (BPB) has been accepted as a reliable alternative for general anesthesia in upper limb surgeries. Adding adjuvant drugs like dexmedetomidine and sufentanil has been shown to have clinical and pharmacologic advantages. In this randomized parallel clinical trial, we aim to compare the effects of these two adjuvants for bupivacaine in BPB. Methods: In this double-blinded study, by using computer-assisted block randomization, 40 patients ranged from 20 to 65 years old and scheduled for elective upper limb surgeries were assigned to two equal study groups (n = 20), receiving 1 mL of 5 μg.mL-1 sufentanil (group S) or 1 mL of 100 μg.mL-1 dexmedetomidine (group D) in adjunction to 30 mL of 0.5% bupivacaine for supraclavicular BPB under the guidance of ultrasonography. Characteristics of local anesthesia and postoperative analgesia were evaluated (n = 40). Results: The duration of blocks significantly improved in group S (sensory: estimated median difference (EMD) [95%CI] = 100.0 [70.0~130.0], p < 0.001; motor: EMD [95%CI] = 120.0 [100.0~130.0], p < 0.001). Group S also had significantly longer postoperative analgesia and lower opioid consumption within 24 hours after the surgery (EMD [95%CI] = 4.0 [3.0~7.0], p < 0.001; EMD [95%CI] = -5.0 [-5.0~-5.0], p < 0.001; respectively). None of the patients showed adverse effects concerning vital signs, nausea, or vomiting. Conclusion: Our study showed that during ultrasound-guided supraclavicular BPB, sufentanil is a fairly better choice than dexmedetomidine as an adjuvant for bupivacaine and can provide preferable sensory and motor blocks. No significant side effects were seen in either of the study groups.
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Humans , Adolescent , Adult , Middle Aged , Aged , Dexmedetomidine/therapeutic use , Brachial Plexus Block , Bupivacaine , Sufentanil , Upper Extremity/surgery , Anesthetics, LocalABSTRACT
Resumen: El estesioneuroblastoma es una neoplasia de las células del neuroepitelio olfatorio. Tiene una baja incidencia de 0.4 por cada millón de habitantes. Se caracteriza por síntomas como sinusitis, epistaxis, cefalea, discapacidad visual, obstrucción nasal, hiposmia y rinorrea. En este reporte se presenta el caso de un paciente masculino de 29 años con estesioneuroblastoma estadio Kadish C, quien fue programado para resección quirúrgica bajo anestesia total intravenosa con resultados satisfactorios durante el procedimiento quirúrgico.
Abstract: Esthesioneuroblastoma is a neoplasm of the olfactory neuroepithelium cells, it has a low incidence of 0.4 per million inhabitants. It is characterized by symptoms such as sinusitis, epistaxis, headache, visual impairment, nasal obstruction, hyposmia, and rhinorrhea. We present the case of a 29-year-old male patient with Kadish C stage esthesioneuroblastoma, who was scheduled for surgical resection under total intravenous anesthesia with satisfactory results during the surgical procedure.
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Abstract Introduction Spinal infusions of either fentanyl or sufentanil have been reported in international reports, articles, and scientific events worldwide. This study aimed to determine whether intrathecal fentanyl or sufentanil offers safety in mortality and perioperative adverse events. Methods MEDLINE (via PubMed), EMBASE, CENTRAL (Cochrane library databases), gray literature, hand-searching, and clinicaltrials.gov were systematically searched. Randomized controlled trials with no language, data, or status restrictions were included, comparing the effectiveness and safety of adding spinal lipophilic opioid to local anesthetics (LAs). Data were pooled using the random-effects models or fixed-effect models based on heterogeneity. Results The initial search retrieved 4469 records; 3241 records were eligible, and 3152 articles were excluded after reading titles and abstracts, with a high agreement rate (98.6%). After reading the full texts, 76 articles remained. Spinal fentanyl and sufentanil significantly reduced postoperative pain and opioid consumption, increased analgesia and pruritus. Fentanyl, but not sufentanil, significantly reduced both postoperative nausea and vomiting, and postoperative shivering; compared to LAs alone. The analyzed studies did not report any case of in-hospital mortality related to spinal lipophilic opioids. The rate of respiratory depression was 0.7% and 0.8% when spinal fentanyl or sufentanil was added and when it was not, respectively. Episodes of respiratory depression were rare, uneventful, occurred intraoperatively, and were easily manageable. Conclusion There is moderate to high quality certainty that there is evidence regarding the safety and effectiveness of adding lipophilic opioids to LAs in spinal anesthesia.
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Humans , Fentanyl/adverse effects , Anesthesia, Spinal/adverse effects , Pain, Postoperative , Sufentanil/adverse effects , Non-Randomized Controlled Trials as Topic , Analgesics, Opioid/adverse effects , Anesthetics, Local/adverse effectsABSTRACT
Objective:To investigate the effect of ropivacaine hydrochloride combined with sufentanil for intraspinal patient-controlled analgesia (PCA) in labor analgesia, and its influence on stress response and pregnancy outcome.Methods:The general data of 97 parturients who underwent intraspinal PCA delivery analgesia in Chengdu Seventh People′s Hospital from April 2019 to March 2021 were retrospectively analyzed. They were divided into the observation group (51 cases) and the control group (46 cases) according to different analgesia methods. The observation group parturients were given ropivacaine hydrochloride combined with sufentanil intraspinal PCA, and the control group parturients were given ropivacaine hydrochloride intraspinal PCA. The numerical scoring system (NRS) was used to evaluate the pain degree of the parturient before, 15 minutes after, 30 minutes after, 45 minutes after analgesia and when the uterine orifice was fully opened. The onset time of analgesia, the time of perfection of analgesia, the amount of ropivacaine hydrochloride, sufentanil and the total amount of analgesic drugs were counted. The levels of serum cortisol (COR), adrenocorticotropic hormone (ACTH) and Norepinephrine (NA) were detected by enzyme-linked immunosorbent assay (ELISA). The time of the first stage of labor, the active stage, the second stage of labor, and the third stage of labor, the amount of vaginal bleeding (during labor and within 2 hours after delivery), the proportion of oxytocin application, normal labor, forceps delivery, lateral perineum resection, and caesarean section, the occurrence of adverse reactions (itching, fever, nausea and vomiting, urinary retention, and fetal bradycardia), and the Apgar score of newborns (1 min and 5 min after birth) were counted.Results:There was no statistically significant difference in the onset time and improvement time of analgesia between the two groups of postpartum women, as well as the NRS scores before and after analgesia at 15, 30, and 45 minutes, as well as when the cervix was fully opened (all P>0.05). The dosage of Ropivacaine hydrochloride and the total amount of analgesics in the observation group were significantly less than those in the control group (all P<0.05). After analgesia, the serum levels of COR, ACTH, and NA in both groups decreased significantly compared to before analgesia (all P<0.05); After analgesia, there was no statistically significant difference in serum COR, ACTH, and NA levels between the two groups (all P>0.05). The second stage of labor in the observation group was shorter than that in the control group, the vaginal bleeding volume and the proportion of caesarean section were lower than those in the control group, the proportion of normal delivery and the Apgar score 1 min after birth of the fetus were higher than those in the control group, and the difference was statistically significant (all P<0.05). There was no statistically significant difference in the analgesic effect and total incidence of adverse reactions between the two groups of postpartum women (all P>0.05). Conclusions:Ropivacaine hydrochloride combined with sufentanil intraspinal PCA can effectively alleviate labor pain, reduce the amount of analgesics, and improve maternal and fetal pregnancy outcomes.
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Objective:To investigate the effects of dezocine combined with sufentanil on continuous epidural analgesia after cesarean section.Methods:Eighty-six pregnant women who were scheduled for cesarean section in Guoyang Hospital of Traditional Chinese Medicine from February to December 2021 were included in this randomized controlled study. These women were divided into an observation group and a control group ( n = 43/group). The women in the observation group underwent epidural analgesia with dizocine, sufentanil, and ropivacaine, while those in the control group underwent epidural analgesia with dizocine and ropivacaine. The visual analogue score, Ramsay sedation score, Bruggrmann comfort scale score, and the incidence of adverse reactions were compared between the two groups. Results:At 4, 8, 12, 24 hours after surgery, the visual analogue score (VAS) in the observation group was significantly lower than that in the control group ( t = 2.34, 5.89, 15.36, 16.23, all P < 0.05). At 4, 8, 12, and 24 hours after surgery, Ramsay sedation score in the observation group was significantly higher than that in the control group ( t = -6.31, -7.64, -7.49, -7.41, all P < 0.001). At 4, 8, 12, and 24 hours after surgery, Bruggrmann comfort scale score in the observation group was significantly higher than that in the control group ( t = -7.60, -10.40, -14.53, -13.80, all P < 0.001). There was a significant difference in the number of effective analgesic pump compressions between the observation and control groups [(3.00 ± 1.41) times vs. (7.23 ± 1.31) times, t = 14.42, P < 0.001]. No adverse reactions were observed in the observation group within 24 hours after surgery. Conclusion:Dezocine combined with sufentanil for epidural analgesia can effectively improve the analgesic effects after cesarean section and is highly safe.
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Objective:To determine the 50% effective concentration (EC 50) of ropivacaine plus sufentanil for labor analgesia using the dural puncture epidural technique. Methods:Using the method of prospective study, sixty parturients requiring labor analgesia in Dalian Women and Children′s Medical Group from May 2021 to May 2022 were divided into six groups using a random number table and administered 0.3 mg/L sufentanil and ropivacaine at different concentrations: 0.05% (group D1), 0.06% (group D2), 0.07% (group D3), 0.08% (group D4), 0.09% (group D5), and 0.1% (group D6). A probit model was constructed to compute the EC 50 values and 95% confidence intervals (95% CI) of ropivacaine plus sufentanil in dural puncture epidural analgesia (DPEA) for labor. The pain intensity of uterine contractions before labor analgesia and 30 min after administration was recorded and assessed on a numeric rating scale (NRS), and decreases in blood pressures and heart rates, vomiting and nausea, postpartum headaches, and fetal bradycardia were documented. Results:When using ropivacaine plus sufentanil for labor analgesia via DPE, the EC 50 was 0.061%, and the 95% CI ranged from 0.051 to 0.067; the 90% effective concentration (EC 90) was 0.081%, and the 95% CI was between 0.074 and 0.098. Among the six groups, there was one case of fetal bradycardia in group D3 and one case of decreased heart rates in group D4. No decreased blood pressure, vomiting and nausea, or postpartum headaches were reported. Conclusions:In DPEA for labor, ropivacaine plus sufentanil has an EC 50 of 0.061%, with the 95% CI falling between 0.051 and 0.067, similar to the EC 50 value in epidural analgesia.
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Objective:To investigate the efficacy of subarachnoid anesthesia with low-dose ropivacaine combined with sufentanil in cesarean delivery.Methods:A total of 120 women who were subjected to cesarean delivery in Tongxiang Second People's Hospital from May 2017 to April 2018 were included in this study. They were randomly assigned to undergo subarachnoid anesthesia either with low-dose ropivacaine plus sufentanil (observation group, n = 60) or low-dose ropivacaine alone (control group, n = 60) in cesarean delivery. The anesthesia effects, heart rate, mean arterial pressure, sensory block, 1-minute Apgar score, and the incidence of adverse reactions were compared between the two groups. Results:Time to anesthesia onset and time to pain recovery in the observation group were (2.07 ± 1.24) minutes and (51.29 ± 6.24) minutes, respectively, which were significantly shorter than those in the control group [(4.58 ± 1.69) minutes, (56.70 ± 7.91) minutes, t = 9.28, 4.16, both P < 0.05]. There was no significant difference in the duration of anesthesia between the two groups ( t = 0.76, P > 0.05). The heart rate, mean arterial pressure, and 1-minute Apgar score were (77.64 ± 6.20) beats/minute, (92.23 ± 1.38) mmHg, and (9.68 ± 0.70) points respectively in the observation group, which were significantly lower than those in the control group [(83.40 ± 5.93) beats/minute, (96.54 ± 4.06) mmHg, (7.59 ± 0.64) points, t = 5.20, 7.79, 17.07, all P < 0.05]. Time to onset of sensory block was significantly shorter in the observation group than in the control group [(52.07 ± 8.68) seconds vs. (64.30 ± 9.62) seconds, t = 7.31, P < 0.05]. Duration of sensory and motor block in the observation group were (161.75 ± 28.63) minutes and (86.26 ± 20.03) minutes, respectively, which were significantly longer than those in the control group [(130.29 ± 31.84) minutes, (78.60 ± 16.95) minutes, t = 5.69, 2.26, both P < 0.05]. The incidence of adverse reactions was significantly lower in the observation group than in the control group (5.00% vs. 16.67%, χ2 = 4.23, P < 0.05). Conclusion:Subarachnoid anesthesia with low-dose ropivacaine combined with sufentanil has satisfactory anesthetic effects in cesarean delivery. The combined therapy can stabilize hemodynamics, has little impact on newborns, and is highly safe.
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Objective:To investigate the efficacy and safety of hydromorphone for postoperative analgesia in children with congenital heart disease, and provide a suitable reference dose for postoperative analgesia in children.Methods:Using a prospective study, 157 patients with congenital heart disease(ASA Ⅱ- Ⅳ) admitted to pediatric intensive care unit at Children′s Hospital of Chongqing Medical University from November 2019 to November 2021 were randomly divided into five groups.Low-dose hydromorphone group (H1 group, 30 cases): hydromorphone dose ≥2 and <3 μg/(kg·h), hydromorphone medium-dose group (H2 group, 30 cases): hydromorphone dose ≥3 and <4 μg/(kg·h), high-dose hydromorphone group (H3 group, 31 cases): hydromorphone dose ≥4 and ≤5 μg/(kg·h), sufentanil group (S group, 36 cases): the dose of sufentanil was 0.08 μg/(kg·h), morphine group (M group, 30 cases): the dose of morphine was 20 μg/(kg·h). The five groups of children received midazolam 2 μg/(kg·min) intravenously at the same time as sedative therapy.Pain score and sedation score were scored at 1 h, 4 h, 8 h, 12 h, and 24 h after operation.Heart rate, mean arterial pressure, blood glucose, lactate, and serum cortisol levels were also monitored and detected, and the occurrence of adverse reactions, the number of cases requiring additional analgesic and sedative drugs, as well as the duration of mechanical ventilation were compared.Results:(1) There were no significant differences regarding the age, body weight, cardiopulmonary bypass time, pediatric critical illness score and ASA score among five groups (all P>0.05). (2) There was no significant difference in the levels of respiration, heart rate, blood sugar, lactate and serum cortisol among five groups after operation.There was no significant difference in preoperative mean arterial pressure among the groups, but there was significant difference in the postoperative mean arterial pressure among the groups at 4 h and 8 h( P<0.05). (3) The analgesic satisfaction of H1 group, H2 group and H3 group at 1 h, 4 h, 12 h and 24 h after operation was significantly higher than that in M group ( P<0.05). There was no significant difference in analgesic satisfaction among H1 group, H2 group and H3 group at each time point.(4) The sedation satisfaction of H1 group, H2 group and H3 group at 4 h and 24 h after operation was significantly higher than that in M group ( P<0.05). There was no significant difference in sedation satisfaction among H1 group, H2 group and H3 group at each time point.(5) There was no significant difference in postoperative analgesia satisfaction and sedation satisfaction between H1 group, H2 group, H3 group and S group.(6) Children in H1 group[1(0, 2)], H2 group[1(0, 2)], H3 group[1(0, 2)] had fewer additional doses within 24 hours than that in M group[2(2, 3)]( P<0.05), and fewer children in H1 group, H2 group and H3 group had been given analgesic sedatives than that in M group ( P<0.05); The extubation time was shortest in H2 group and S group[H2 group(88.3±2.9) h, S group(85.9±3.0) h]. (7) There were no adverse reactions in H1 group, H2 group, H3 group and S group, and there were two cases of apnea in M group. Conclusion:The analgesic effect of hydromorphone in children with congenital heart disease after surgery is better than that of morphine, and the effect of hydromorphone is comparable to that of sufentanil.Hydromorphone 3-4 μg/(kg·h)+ midazolam 2 μg/(kg·min) can achieve satisfactory analgesic and sedative effects in children after congenital heart surgery, with few adverse reactions, safe and reliable, which is an excellent choice for postoperative analgesia and sedation in children.
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Objective:To evaluate the optimization efficacy of ropivacaine mixed with nalbuphine for epidural labor analgesia through comparison with ropivacaine mixed with sufentanil in primiparas.Methods:Four hundred and forty primiparas with a singleton fetus in vertex presentation without abnormal fetus, aged 19-36 yr, at 37-42 weeks of gestation, who were suitable and volunteered to receive epidural labor analgesia, were selected and randomly divided into observation group (NR group, n=220) and conventional group (C group, n=220).Epidural labor analgesia solution contained nalbuphine 40 mg and ropivacaine 120 mg in 150 ml of normal saline in group NR.Epidural labor analgesia solution contained sufentanil 50 μg and ropivacaine 120 mg in 150 ml of normal saline in group C. The analgesia pump was set up to deliver a 5 ml bolus dose with a 20-min lockout interval, programmed intermittent bolus 10-15 ml/h and background infusion at 2 ml/h after an initial dose of 15 ml to maintain VAS score <3.The length of labor, adverse reactions during labor analgesia, neonatal Apgar score, parameters of umbilical artery blood gas analysis and neonatal behavioral neurological assessment score were recorded. Results:Compared with group C, the incidence of urinary retention, pruritus, nausea and vomiting and fever at birth was significantly decreased in group NR ( P<0.05).The duration of the first and second stages of labor, neonatal Apgar score, pH value of umbilical artery blood, lactate concentrations, and neonatal behavioral neurological assessment score were within the normal range in both groups, and there was no significant difference between the two groups ( P>0.05). Conclusions:Compared with conventional medication, nalbuphine mixed with ropivacaine has the same efficacy when used for epidural labor analgesia in primiparas, but it has a certain optimization efficacy in terms of safety.
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Objective:To investigate the effects of hydromorphone on early postoperative recovery, postoperative analgesia and stress response in patients undergoing laparoscopic radical resection of colorectal cancer.Methods:120 patients with colorectal cancer who underwent laparoscopic radical resection of colorectal cancer in Taizhou Hospital of Zhejiang Province from June 2019 to June 2020 were included in this study. They were randomly assigned to undergo either postoperative patient-controlled intravenous analgesia with hydromorphone (observation group, n = 60) or postoperative patient-controlled intravenous analgesia with sugentanil (control group, n = 60). The changes of perioperative indexes, postoperative recovery, Visual Analogue Scale score at 3, 12 and 24 hours post-surgery, stress response [norepinephrine, interleukin-6 and cortisol] before and 3 days after surgery were compared between the two groups. Results:There were no significant differences in operative time and intraoperative blood loss between the two groups (both P > 0.05). The time to intestinal peristalsis, the time to getting out of bed, and the time to drainage tube removal in the observation group were (57.83 ± 8.98) hours, (43.12 ± 2.34) hours, and (121.38 ± 10.29) hours, which were significantly shorter than those in the control group [(65.21 ± 7.45) hours, (45.46 ± 2.19) hours and (150.28 ± 13.42) hours, t = 4.899, 5.656 and 13.238, all P < 0.05]. Visual Analogue Scale score in the observation group at 12 and 24 hours after surgery was (1.89 ± 0.27) points and (1.45 ± 0.23) points, respectively, which was significantly lower than that in the control group [(2.19 ± 0.24) points, (1.84 ± 0.20) points, t = 6.433, 9.911, both P < 0.05]. At 3 days after surgery, serum levels of norepinephrine, interleukin-6 and cortisol in the observation group were (185.49 ± 18.29) ng/L, (59.91 ± 6.89) ng/L, and (109.21 ± 15.46) μg/L, respectively, which were significantly lower than those in the control group [(235.41 ± 16.57) ng/L, (73.24 ± 7.68) ng/L, (128.39 ± 10.32) μg/L, t = 15.668, 10.008, 7.993, all P < 0.05]. Conclusion:Hydromorphone exhibits a good effect on laparoscopic radical resection of colorectal cancer because it can promote early postoperative recovery, has an obvious postoperative analgesic effect and little influence on stress response.
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Objective:To study the effect of different sufentanil doses on hemodynamics and interleukin (IL)-6 in children with ventricular septal defect repair (VSDR).Methods:A total of 96 children who underwent VSDR surgery in Three Gorges Hospital Affiliated to Chongqing University from January 2016 to June 2019 were selected. Children with VSDR were enrolled and divided into A group (0.8 μg/kg), B group (1.0 μg/kg) and C group (1.1 μg/kg) according their sufentanil doses. The heart rate (HR), contraction pressure (SBP), the brain electric double frequency index (BIS) and IL-6 in different time were studied and compared. The adverse cardiovascular events and other indicators were studied and compared.Results:At t 2 to t 6, there were significant difference among the three groups in HR, A group: (104.62 ± 10.58), (128.73 ± 13.29), (127.59 ± 13.53), (125.62 ± 12.60) and (118.49 ± 11.62) times/min, B group: (100.27 ± 10.11), (119.33 ± 12.62), (116.57 ± 11.40), (113.57 ± 11.94) and (113.37 ± 11.46) times/min, C group: (87.92 ± 8.87), (98.62 ± 9.69), (94.42 ± 9.38), (88.72 ± 8.62) and (89.36 ± 9.17) times/min; SBP, A group: (79.54 ± 7.59), (102.75 ± 10.62), (90.62 ± 9.52), (85.19 ± 8.62) and (83.98 ± 8.62) mmHg (1 mmHg = 0.133 kPa), B group: (76.74 ± 7.28), (90.45 ± 9.57), (87.38 ± 8.51), (84.72 ± 8.50) and (83.77 ± 8.58) mmHg, C group: (70.62 ± 7.27), (75.62 ± 7.83), (72.69 ± 7.80), (71.28 ± 7.43) and (71.39 ±7.16) mmHg, P<0.05. At t 2 to t 4, there were significant differences among the three groups in BIS, A group: 48.64 ± 5.03, 53.58 ± 5.71 and 59.61 ± 5.87, B group: 48.79 ± 5.12, 50.23 ± 5.24 and 57.75 ± 5.66, C group: 43.59 ± 4.62, 50.31 ± 5.34, 55.26 ± 5.53, P<0.05. At T 2 to T 6, there was a significant difference among the three groups in IL-6, A group: (0.41 ± 0.06), (0.49 ± 0.11), (0.53 ± 0.13), (0.82 ± 0.17) and (0.61 ± 0.15) μg/L, B group: (0.38 ± 0.05), (0.42 ± 0.08), (0.46 ± 0.09), (0.75 ± 0.14) and (0.53 ± 0.12) μg/L, C group: (0.35 ± 0.05), (0.40 ± 0.06), (0.43 ± 0.07), (0.72 ± 0.12) and (0.51 ± 0.11) μg/L, P<0.05. Compared with that in A group and C group, HR, SBP and BIS in B group had relatively low volatility. At T 2 to T 6, IL-6 level in A group was significantly higher than that in B group and C group, and there was a statistically significant difference ( P<0.05). The incidence of cardiovascular adverse events in A group and C group was significantly higher than that in B group, and there was statistical difference ( P<0.05). Conclusions:1.0 μg/kg sufentanil can have less effect on hemodynamics and IL-6 in children with VSDR with less adverse cardiovascular events and other indicators.
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Abstract Objective: The aim of this study was to evaluate whether sufentanil can reduce emergence delirium in children undergoing transthoracic device closure of ventricular septal defect (VSD) after sevoflurane-based cardiac anesthesia. Methods: From February 2019 to May 2019, 68 children who underwent transthoracic device closure of VSD at our center were retrospectively analyzed. All patients were divided into two groups: 36 patients in group S, who were given sufentanil and sevoflurane-based cardiac anesthesia, and 32 patients in group F, who were given fentanyl and sevoflurane-based cardiac anesthesia. The following clinical data were recorded: age, sex, body weight, operation time, and bispectral index (BIS). After the children were sent to the intensive care unit (ICU), pediatric anesthesia emergence delirium (PAED) and face, legs, activity, cry, consolability (FLACC) scale scores were also assessed. The incidence of adverse reactions, such as nausea, vomiting, drowsiness and dizziness, was recorded. Results: There was no significant difference in age, sex, body weight, operation time or BIS value between the two groups. Extubation time (min), PEAD score and FLACC scale score in group S were significantly better than those in group F (P<0.05). No serious anesthesia or drug-related side effects occurred. Conclusions: Sufentanil can be safely used in sevoflurane-based fast-track cardiac anesthesia for transthoracic device closure of VSD in children. Compared to fentanyl, sufentanil is more effective in reducing postoperative emergence delirium, with lower analgesia scores and greater comfort.
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Humans , Male , Female , Child , Anesthetics, Inhalation , Emergence Delirium , Anesthesia, Cardiac Procedures , Heart Septal Defects, Ventricular/surgery , Adjuvants, Anesthesia/therapeutic use , Methyl Ethers , Retrospective Studies , Sufentanil/therapeutic use , SevofluraneABSTRACT
Objective@#To investigate the clinical value of sufentanil combined with propofol anesthesia in cerebral hemorrhage in basal ganglia.@*Methods@#From November 2015 to June 2018, 100 patients with cerebral hemorrhage in the basal ganglia of the People's Hospital of Shanxi Province were enrolled and randomly divided into two groups according to the digital table, with 50 cases in each group.The control group received fentanyl+ propofol, and the study group received sufentanil + propofol.At T0 (before induction of anesthesia), T1 (after anesthesia induction), T2 (after tracheal intubation), T3 (surgery), the hemodynamic parameters[mean arterial pressure (MAP), heart rate (HR)] level, postoperative recovery time (recovery of spontaneous breathing, recovery time and extubation time), preoperative and postoperative 6 h serum angiotensin Ⅱ (Ang Ⅱ), renin activity (PRA), neuron specific enolase (NSE) ), glial fibrillary acidic protein (GFAP) levels, the incidence of adverse reactions of the two groups were counted.@*Results@#(1)Hemodynamics: MAP and HR levels in the two groups were higher in T1, T2 and T3 than those in T0(all P<0.05), and HR and MAP in the study group were lower than those in the control group (all P<0.05). (2)Postoperative recovery: the time of extubation, recovery time and spontaneous breathing time of the study group were (12.42±3.27)min, (9.10±1.95)min, (7.32±2.23)min, respectively, which were shorter than those of the control group[(15.30±3.35)min, (12.67±2.18)min, (8.96±2.48)min] (t=4.350, 8.631, 3.477, all P<0.05). (3)Serum Ang Ⅱ and PRA: the serum Ang Ⅱ and PRA levels in the two groups at 6 h after surgery were higher than those before surgery(all P<0.05), and Ang Ⅱ, PRA levels of the study group were lower than those of the control group (t=4.350, 8.631, 3.477, all P<0.05). (4) Serum NSE and GFAP: the serum NSE and GFAP levels in the two groups at 6 h after surgery were higher than those before surgery(all P<0.05), and NSE, GFAP levels of the study group were lower than those of the control group (all P<0.05). (5) Adverse reactions: the incidence of adverse reactions in the study group [12.0%(6/50)] was lower than that in the control group [28.0%(14/50)] (χ2=4.000, P<0.05).@*Conclusion@#Sufentanil combined with propofol anesthesia in patients with cerebral hemorrhage in the basal ganglia can promote hemodynamic fluctuations, inhibit the increase of Ang Ⅱ and PRA, NSE and GFAP, and has less adverse reactions and high security.
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Objective@#To compare the effects of remifentanil and sufentanil on hemodynamics, recovery and cognitive function in patients undergoing laparoscopic cholecystectomy.@*Methods@#A total of 136 patients undergoing laparoscopic cholecystectomy in Second People′s Hospital of Fuyang District of Hangzhou from March 2013 to March 2018 were collected and divided into two groups, with 68 patients in each group. The remifentanil group was given conventional anesthesia induction and remifentanil anesthesia maintenance, while the sufentanil group was given conventional anesthesia induction and sufentanil anesthesia maintenance. The levels of hemodynamics, awakening, cognitive function and complications of the two groups were compared.@*Results@#The levels of hemodynamics (heart rate, systolic blood pressure, diastolic blood pressure) in sufentanil group was stable than those in remifentanil group. Compared with the remifentanil group, the respiratory recovery time, eye opening time and extubation time of sufentanil group were all increased [(10.01 ± 1.25) min vs. (8.17 ± 0.82) min, (10.27 ± 1.39) min vs. (8.05 ± 0.72) min, (14.65 ± 1.51) min vs. (11.08 ± 1.03) min] (P<0.05). In addition, the scores of mini mental state examination (MMSE) on the 1st day after operation in both groups were lower than those on the 3rd day before and after operation, and the scores in remifentanil group were significantly lower than those in sufentanil group, and the scores of sufentanil group were significantly higher on the 1st day after operation [(21.04 ± 2.02) scores vs. (25.08 ± 2.31) scores] (P< 0.05). The incidence of abdominal distension, nausea and vomiting in sufentanil group was significantly lower than those in remifentanil group [2.94%(2/68) vs. 13.24%(9/68), 5.88%(4/68) vs. 26.47%(18/68)] (P<0.05).@*Conclusions@#Compared with remifentanil group, sufentanil group has less influence on hemodynamics, faster recovery of cognitive function and less incidence of adverse reactions in patients undergoing laparoscopic cholecystectomy.
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Objective To compare the effects of remifentanil and sufentanil on hemodynamics,recovery and cognitive function in patients undergoing laparoscopic cholecystectomy.Methods A total of 136 patients undergoing laparoscopic cholecystectomy in Second People's Hospital of Fuyang District of Hangzhou from March 2013 to March 2018 were collected and divided into two groups,with 68 patients in each group.The remifentanil group was given conventional anesthesia induction and remifentanil anesthesia maintenance,while the sufentanil group was given conventional anesthesia induction and sufentanil anesthesia maintenance.The levels of hemodynamics,awakening,cognitive function and complications of the two groups were compared.Results The levels of hemodynamics (heart rate,systolic blood pressure,diastolic blood pressure) in sufentanil group was stable than those in remifentanil group.Compared with the remifentanil group,the respiratory recovery time,eye opening time and extubation time of sufentanil group were all increased [(10.01 ± 1.25) min vs.(8.17 ± 0.82) min,(10.27 ± 1.39) min vs.(8.05 ± 0.72) min,(14.65 ± 1.51) min vs.(11.08 ± 1.03) min] (P＜0.05).In addition,the scores of mini mental state examination (MMSE) on the 1st day after operation in both groups were lower than those on the 3rd day before and after operation,and the scores in remifentanil group were significantly lower than those in sufentanil group,and the scores of sufentanil group were significantly higher on the 1st day after operation [(21.04 ± 2.02) scores vs.(25.08 ± 2.31) scores] (P ＜0.05).The incidence of abdominal distension,nausea and vomiting in sufentanil group was significantly lower than those in remifentanil group [2.94％(2/68) vs.13.24％(9/68),5.88％(4/68) vs.26.47％(18/68)](P＜ 0.05).Conclusions Compared with remifentanil group,sufentanil group has less influence on hemodynamics,faster recovery of cognitive function and less incidence of adverse reactions in patients undergoing laparoscopic cholecystectomy.
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Objective To compare the perioperative application of sufentanil and oxycodone in patients undergoing laparoscopic surgery for gastric or colorectal cancer. Methods 59 patients were selected and randomly divided into group O and group S. Anesthesia was induced with sufentanil 0.3 μg/kg in group S and oxycodone 0.3 mg/kg in group O. Anesthesia was maintained with sevoflurane balanced anesthesia. When heart rate or blood pressure reached 20% over the baseline, additional dose of oxycodone 0.1 mg/kg was given in group O and sufentanil 0.1 μg/kg in group S. 30 minutes before the end of surgery, patients in group S received sufentanil 0.1 μg/kg and group O with oxycodone 0.1 mg/kg separately. Two hours in the PACU, a rescue dose of sufentanil 0.1 μg/kg or oxycodone 0.1 mg/kg was given to the patients with VAS score bigger than 4. Hemodynamic index, VAS score, Ramsay score, adverse responses and analgesics rescue were recorded. Results No difference was found in hemodynamic index, VAS score and analgesics rescue between the two groups (P>0.05). Ramsay score of group S is lower than that of group O (P=0.014). Induction period bucking incidence in group O was obviously lower than that in group S(P=0.002). The incidence of emergency agitation in group O was significantly lower than that in group S(P=0.045).There was no significant difference in respiratory depression, postoperative nausea and vomiting between two groups (P>0.05). Conclusion Compared with sufentanil, oxycodone significantly reduced the incidence of bucking and emergency agitation. Oxycodone provided better sedation to patients who received laparoscopic surgery for gastric or colorectal cancer.
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Objective To analyze the effects of nabuprofen combined with sufentanil on Ramsay sedation score,visual analogue scale (VAS) and analgesic effect in patients undergoing total hip arthroplasty (THA) for patient-controlled intravenous analgesia (PCIA).Methods From January 2017 to December 2017,72 patients with THA in the Department of Orthopedics from the People's Hospital of Linfen were divided into three groups:A group was given nabuprofen,B group was given sufentanil,C group was given nabuprofen + sufentanil,with 24 cases in each group.Ramsay sedation score,VAS score and analgesic effect were compared among the three groups before and after operation.Results The Ramsay sedation scores of A group at 3,12 and 24 hours after operation were (2.78 ±0.32) points,(2.59 ± 0.40) points and (2.4 ± 0.26) points,respectively,and the Ramsay sedation scores of C group at 3,12 and 24 hours after operation were (2.37 ± 0.24) points,(2.0 ± 0.15) points,(1.89 ± 0.22) points,respectively,which were decreased significantly compared with those of B group at the same time point [(3.07 ± 0.58) points,(3.01 ±0.62)points and (2.73 ±0.47)points] (Fbetween group =6.83,Pbetween group =0.01;Ftime point =7.24,Ptime point ＜0.01;Fbeyween group· time point =0.69,Pbetween group.timepoint =0.40).The VAS scores of group B at 3,12 and 24 hours after operation were (2.40 ± 0.72) points,(1.98 ± 0.57) points and (1.24 ± 0.38) points,respectively,and the VAS scores of C group at 3,12 and 24 hours after operation were (2.35 ± 0.75) points,(1.74 ± 0.46) points and (1.18 ±0.26) points,respectively,which were decreased significantly compared with those of A group at the same time point [(3.35 ± 0.59) points,(3.18 ± 0.46) points and (3.01 ± 0.33) points] (Fbetween group =7.02,Pbetween group ＜ 0.01;Ftime point =5.42,Ptime point =0.02;Fbetween group· time point =0.39,Pbetween gronp· time point =0.68).There was statistically significant difference among the three groups (x2 =7.66,P ＜0.05).The analgesic satisfaction of C group (91.67％) was significantly higher than that of A group (58.33％) and B group (62.50％) (x2 =5.44,4.25,all P ＜ 0.05).Conclusion The sedative and analgesic effects of PCIA nabuprofen combined with sufentanil for patients with THA are definite and comfortable,which can effectively alleviate pain,so it has a definite clinical application value.
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OBJECTIVE@#To compare the efficacy and safety of postoperative analgesia with low-dose sufentanil combined with transversus abdominis plane (TAP) block and with sufentanil alone in promoting patients'recovery following laparoscopic hysterectomy.@*METHODS@#Sixty patients undergoing laparoscopic hysterectomy in our hospital between September, 2016 and August, 2017 were randomly allocated into two equal groups. In group A, the patients were given postoperative analgesia with 1 μg/kg sufentanil, 9.96 mg tropisetronmesylate, and 200 mg flurbiprofen axetil (diluted with 0.9% NaCl solution to 100 mL, pumped at the rate of 2 mL/h) combined with TAP block; in group B, the patients received similar postoperative analgesia but at a higher dose of sufentanil (2 μg/kg) without TAP block. Visual analogue scale (VAS) was used to evaluate pain at 15 min and at 4, 8, 12, 24 and 48 h postoperatively, and the first off-bed time, the length of postoperative hospital stay and the incidence of postoperative nausea and vomiting (PONV) were recorded in all the patients.@*RESULTS@#Compared with those in group B, the patients in group A had significantly lower VAS scores at 15 min, 4 h, 8 h, and 12 h postoperatively ( < 0.01) with also statistically shorter first off-bed time and postoperative hospital stay ( < 0.01). Two (6.7%) patients in group A had mild PONV, and 6 (20.0%) in group B had PONV (including 4 with mild and 2 with moderate PONV).@*CONCLUSIONS@#Lowdose sufentanil combined with TAP block is effective for postoperative analgesia after laparoscopic hysterectomy and helps to reduce the incidence of PONV and shorten the first off-bed time and postoperative hospital stay to promote the recovery of the patients.
Subject(s)
Female , Humans , Abdominal Muscles , Analgesics, Opioid , Hysterectomy , Laparoscopy , Pain Measurement , Pain, Postoperative , SufentanilABSTRACT
Objective@#To explore the anesthetic effect of sufentanil combined with propofol with different target control concentration for breast cancer patients.@*Methods@#From January 10, 2015 to December 20, 2017, according to the digital table, 80 patients with breast cancer in the Maternal and Child Health Hospital of Cixi were randomly divided into three groups: group A(28 cases, the intraoperative sufentanil plasma target control concentration was 0.2ng/mL), group B (27 cases, the intraoperative sufentanil plasma target control concentration was 0.4ng/mL), group C (24 cases, the intraoperative sufentanil plasma target control concentration was 0.8ng/mL). The plasma target control concentration of propofol in three groups was 3μg/mL.The hemodynamic level[mean arterial pressure(MAP), heart rate(HR)], blood oxygen saturation(SpO2), recovery time, respiratory recovery time and incidence of adverse reactions were compared among the three groups.@*Results@#The MAP of T2, T3 and T4 in group A, group B and group C[T2: (78.56±7.42)mmHg vs.(76.98±7.65)mmHg vs.(69.36±7.69)mmHg; T3: (88.24±7.61)mmHg vs.(86.95±7.59)mmHg vs.(69.41±7.70)mmHg; T4: (72.32±7.51)mmHg vs.(69.24±7.21)mmHg vs.(66.52±6.85)mmHg], HR[T2: (73.65±8.75)times/min vs.(73.49±8.69)times/min vs.(68.36±7.79)times/min; T3: (76.75±8.95)times/min vs.(75.58±7.96)times/min vs.(68.65±7.36)times/min; T4: (71.42±7.41)times/min vs.(70.24±6.49)times/min vs.(64.39±6.62)times/min] showed significant differences[F(MAP)= 8.524, 15.365, 5.325; F(HR)=8.104, 12.521, 5.015, all P<0.05]. However, there were no statistically significant differences in SpO2 among group A, group B and group C in T2, T3 and T4(all P>0.05). There were no statistically significant differences in resuscitation time and respiratory recovery time among group A, group B and group C (all P>0.05). There was no statistically significant difference in the incidence of adverse reactions among group A, group B and group C(P>0.05).@*Conclusion@#0.8ng/mL sufentanil combined with 3μg/mL propofol has better anesthetic effect on patients undergoing breast cancer surgery, which is helpful to maintain hemodynamic stability.
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Objective@#To analyze the effects of nabuprofen combined with sufentanil on Ramsay sedation score, visual analogue scale (VAS) and analgesic effect in patients undergoing total hip arthroplasty (THA) for patient-controlled intravenous analgesia (PCIA).@*Methods@#From January 2017 to December 2017, 72 patients with THA in the Department of Orthopedics from the People's Hospital of Linfen were divided into three groups: A group was given nabuprofen, B group was given sufentanil, C group was given nabuprofen + sufentanil, with 24 cases in each group.Ramsay sedation score, VAS score and analgesic effect were compared among the three groups before and after operation.@*Results@#The Ramsay sedation scores of A group at 3, 12 and 24 hours after operation were (2.78±0.32)points, (2.59±0.40)points and (2.4±0.26)points, respectively, and the Ramsay sedation scores of C group at 3, 12 and 24 hours after operation were (2.37±0.24)points, (2.0±0.15)points, (1.89±0.22)points, respectively, which were decreased significantly compared with those of B group at the same time point [(3.07±0.58)points, (3.01±0.62)points and (2.73±0.47)points] (Fbetween group=6.83, Pbetween group=0.01; Ftime point=7.24, Ptime point<0.01; Fbetween group·time point=0.69, Pbetween group·time point=0.40). The VAS scores of group B at 3, 12 and 24 hours after operation were (2.40±0.72)points, (1.98±0.57)points and (1.24±0.38)points, respectively, and the VAS scores of C group at 3, 12 and 24 hours after operation were (2.35±0.75)points, (1.74±0.46)points and (1.18±0.26)points, respectively, which were decreased significantly compared with those of A group at the same time point [(3.35±0.59)points, (3.18±0.46)points and (3.01±0.33)points] (Fbetween group=7.02, Pbetween group<0.01; Ftime point=5.42, Ptime point=0.02; Fbetween group·time point=0.39, Pbetween group·time point=0.68). There was statistically significant difference among the three groups (χ2=7.66, P<0.05). The analgesic satisfaction of C group (91.67%) was significantly higher than that of A group (58.33%) and B group (62.50%) (χ2=5.44, 4.25, all P<0.05).@*Conclusion@#The sedative and analgesic effects of PCIA nabuprofen combined with sufentanil for patients with THA are definite and comfortable, which can effectively alleviate pain, so it has a definite clinical application value.