Effect of Different Sufentanil Concentration Regimens on Postoperative Pain Control and Its Adverse Events in Intravenous Patient-controlled Analgesia / 中国医学科学院学报

ABSTRACT

Objective To compare the analgesic effect and incidences of adverse events of different sufentanil concentration regimens in postoperative intravenous patient-controlled analgesia(PCA).Methods We retrospectively analyzed the clinical data of 6231 patients undergoing elective general anesthesia using sufentanil as postoperative intravenous PCA regimen in Peking Union Medical College Hospital from January 2004 to December 2016.These patients were subcategorized into 4 groups according to the sufentanil concentration regimens0.4 μg/ml(SF4,n=1421),0.6 μg/ml(SF6,n=2489),0.8 μg/ml(SF8,n=1326),and 1.0 μg/ml(SF10,n=995).Total drug consumption within 48 h after surgery,analgesic effect,and incidences of adverse events were compared among these four groups.Results The cohort consisted of 2874 males(46.1%)and 3357 females(53.9%)in the age group from 3 years to 91 years(median52.5 years).The postoperative 48 h sufentanil consumption was significantly different among these four groups in terms of volume(χ=87.316,P<0.001)and dosage(χ=20.261,P<0.001).Meanwhile,the VAS scores at rest and during activity on postoperative day 1(POD1)and POD2 showed no statistical significance among these four groups (both P>0.05).As for the adverse events,the sedation score in POD1(χ=9.042,P=0.029)and incidence of no bowl movement on both POD1(χ=7.855,P=0.012)and POD2(χ=5.635,P=0.044)were significantly different among groups,whereas the incidences of other adverse events showed no significant difference(all P>0.05).Conclusion In patients using intravenous sufentanil PCA as their postoperative analgesia regimen after general anesthesia,regimens with higher sufentanil concentrations may result in more adverse events such as sedation and no bowl movement without improving analgesic outcomes.