BACKGROUND Gastric cancer(GC)is a prevalent tumor in the digestive system,with around one million new cases reported annually,ranking it as the third most common malignancy.Reducing pain is a key research focus.This s...BACKGROUND Gastric cancer(GC)is a prevalent tumor in the digestive system,with around one million new cases reported annually,ranking it as the third most common malignancy.Reducing pain is a key research focus.This study evaluates the effect of nalbuphine on the analgesic effect and the expression of pain factors in patients after radical resection.AIM To provide a reference for postoperative analgesia methods.METHODS One hundred eight patients with GC,admitted between January 2022 and June 2024,underwent radical gastrectomy.They received a controlled analgesia pump and a transverse abdominis muscle plane block,divided into two groups of 54 patients in each group.The control group received sufentanil,while the observation group received nalbuphine as an analgesic.Postoperative analgesic effects,pain factor expression,and adverse effects were compared.RESULTS The resting pain and activity pain scores in the observation group at 6,12,24 and 48 hours were significantly lower than those in the control group.Additionally,the number of presses and consumption of the observation group at 48 hours were lower than those of the control group;and the response rate of the observation group was higher than that of the control group(P<0.05).The prostaglandin E2,substance P,and serotonin levels 24 hours after the observation group were lower than those in the control group,and the incidence of adverse reactions was 5.56%lower than 22.22%in the control group(P<0.05).CONCLUSION The findings suggest that nalbuphine enhances postoperative multimodal analgesia in patients with radical GC,effectively improving postoperative analgesic effect,relieving postoperative resting and active pain,and reducing postoperative pain factor expression,demonstrating its potential for clinical application.展开更多
Objective:To evaluate the analgesic effect and safety of hydromorphone hydrochloride in PCIA combined with flurbiprofen axetil and pre-emptive analgesia in patients with TACE treatment for hepatocellular carcinoma.Met...Objective:To evaluate the analgesic effect and safety of hydromorphone hydrochloride in PCIA combined with flurbiprofen axetil and pre-emptive analgesia in patients with TACE treatment for hepatocellular carcinoma.Methods:Backward observation was made on 90 patients with advanced liver carcinoma who performed TACE treatment in the First Affiliated Hospital of Sun Yat-sen University from January 2022 to October 2023,dividing them into Group A(continuous pump injection of 6 mg hydromorphone+50mg flurbiprofen ester as background injection for 2 ml/h,additional single injection of 3 ml/10min,15 minutes before surgery)and Group B(intravenous injection of 50 mg flurbiprofen ester during the operation,additional injection of tramadol 100 mg intramuscular injection if necessary).Groups were compared and analyzed at different time points in surgery and post-operation time from pain level(NRS),side effects,inflammatory indexes(PCT,IL-6),satisfaction rate.Result:NRS scores at 5 time points,during operation,immediately post-surgery,12,24 hours post-operation,Group A were significantly lower than Group B(Group A during operation 3.0,immediate postoperation 3.0 to 24h 1.0;Group 4.0 to 24h 1.0,all P>0.05).The rate of adverse reactions were comparable between the two groups(all P>0.05).The amount of PCT(0.23 ng/ml vs 1.15 ng/ml)and IL-6(54.49 pg/ml vs 233.49 pg/ml)decreased post-surgery in Group A compared to Group B,but were not statistically significant difference(P=0.424/P=0.502),and more patients in Group A were relieved to grade score of pain relief 4 or above(86.7%vs.60%,P=0.001).Conclusions:Pre-emptive analgesia treatment using PCIA of hydromorphone hydrochloride combined with flurbiprofen axetil has better analgesic effect than routine analgesic therapy in postoperative care of mid to advanced hepatocellular carcinoma TACE,has good safety,and is worth of further promotion and verifying.展开更多
Objective:To investigate the application effect of dexmedetomidine in anesthesia for thyroid cancer(TC)surgery.Methods:A total of 90 patients admitted to our hospital from January 2023 to December 2023 were selected a...Objective:To investigate the application effect of dexmedetomidine in anesthesia for thyroid cancer(TC)surgery.Methods:A total of 90 patients admitted to our hospital from January 2023 to December 2023 were selected as the study subjects.The patients were divided into an observation group(given continuous intravenous infusion of dexmedetomidine during surgery)and a control group(given continuous intravenous infusion of an equal volume of sodium chloride injection during surgery)by lottery method,and the anesthesia indicators of the two groups were compared.Results:The dosages of remifentanil and propofol in the observation group were lower than those in the control group(p<0.05);the incidence of complications in the observation group was lower than that in the control group(p<0.05);the Visual Analogue Scale(VAS)scores of the observation group at 4 h,12 h,24 h,and 48 h postoperatively,both at rest and during activity,were lower than those of the control group(p<0.05).Conclusion:During surgery for TC patients,continuous intravenous infusion of dexmedetomidine can reduce the dosage of anesthetic drugs and the incidence of anesthesia-related complications,alleviate postoperative pain,and is worthy of promotion and application.展开更多
The significance of glial cells in the nervous system,particularly in the modulation of pain,has increasingly gained prominence,thereby shifting the traditional neurobiological research paradigm that predominantly foc...The significance of glial cells in the nervous system,particularly in the modulation of pain,has increasingly gained prominence,thereby shifting the traditional neurobiological research paradigm that predominantly focused on neurons.Acupuncture treatment have been shown to influence the functionality of glial cells,enabling them to serve as modulators that significantly contribute to the inhibition of neurogenic inflammation,the restoration of synaptic homeostasis,and the enhancement of the pain modulation system.Furthermore,various molecules and their associated signaling pathways facilitate the biological effects of glial cells in the context of acupuncture-induced analgesia.Notably,P2X receptors(P2X3,P2X4,and P2X7),the MAPK pathway(including p38MAPK and ERK),and the JAK/STAT pathway within glial cells are implicated in the modulation of neuroinflammation and pain regulation through acupuncture.These elucidated mechanisms underscore the potential of acupuncture to modulate neuroimmune signaling for pain alleviation and suggest the prospect of developing more targeted and effective treatments for chronic pain in the future.展开更多
BACKGROUND Patients who undergo cardiac surgery often face postoperative pain and potential cognitive issues.Multimodal analgesia may address these problems.We hypothesized that multimodal analgesia can reduce opioid ...BACKGROUND Patients who undergo cardiac surgery often face postoperative pain and potential cognitive issues.Multimodal analgesia may address these problems.We hypothesized that multimodal analgesia can reduce opioid use and improve cognitive recovery.AIM To investigate the effects of multimodal analgesia on postoperative opioid consumption and cognitive recovery in patients who underwent cardiac surgery.METHODS A prospective,randomized controlled trial at General Hospital from January 2020 to April 2023 recruited a total of 150 adult patients who underwent elective cardiac surgery.The patients were randomly divided into two groups.Group A had patient-controlled intravenous analgesia with sufentanil and flurbiprofen axil.Group B had flurbiprofen axil and paravertebral nerve block.Data were analyzed with appropriate statistical methods.RESULTS Group B had lower postoperative patient-controlled intravenous analgesia drug consumption(2.21 mL/hour vs 4.26 mL/hour,P<0.001),shorter extubation time(2.32 hours vs 3.81 hours,P<0.001),and intensive care unit stay(15.32 h vs 28.63 h,P<0.001).Visual Analogue Scale pain scores were lower in group B(P<0.001).Group B had fewer postoperative complications(no respiratory depression vs 37.9%in group A,P<0.05),a lower postoperative cognitive dysfunction incidence(16.0%vs 28.0%,P<0.05),and higher Barthel Index scores(P<0.05).CONCLUSION Multimodal analgesia with paravertebral nerve block and flurbiprofen axil reduces opioid use and improves cognitive outcomes in patients who underwent cardiac surgery.展开更多
Background Postoperative pain,if not effectively controlled,can trigger sympathetic activation and stress responses that increase the risk of cardiovascular complications.Oxycodone,a semisynthetic opioid acting on bot...Background Postoperative pain,if not effectively controlled,can trigger sympathetic activation and stress responses that increase the risk of cardiovascular complications.Oxycodone,a semisynthetic opioid acting on bothμ-andκ-receptors,may provide stable analgesia with less hemodynamic fluctuation compared with the pureμ-agonist sufentanil.This study aimed to compare the efficacy and cardiovascular safety of oxycodone-based versus sufent anil-based intravenous patient-controlled analgesia(IV-PCA)after laparoscopic abdominal surgery.Methods This single-center retrospective comparative study included patients who underwent laparoscopic abdominal surgery between March 2024 and March 2025.According to their postoperative PCA regimen,patients were divided into an oxycodone group and a sufentanil group.The primary endpoint was the incidence of cardiovascular adverse events(CVAE)within 48 h after surgery,including hypotension,bradycardia,and arrhythmia.Logistic regression was used to identify independent predictors of CVAE,and receiver operating characteristic(ROC)analysis assessed discriminative performance.Results A total of 356 patients were analyzed(oxycodone n=197;sufentanil n=159).The incidence of CVAE was significantly lower in the oxycodone group than in the sufentanil group(5.2%vs.12.1%,P=0.021).Oxycodone provided comparable analgesic intensity with fewer PCA bolus attempts(36±15 vs.52±17,P<0.001)and higher patient satisfaction scores(4.3±0.5 vs.4.1±0.5,P=0.002).Multivariate logistic regression identified sufentanil use(OR:2.53,95%CI:1.16-5.84,P=0.018)as independent predictors of CVAE.Conclusions Oxycodone-based IV-PCA provided effective postoperative analgesia with a lower incidence of cardiovascular adverse events compared with sufentanil-based PCA.The results suggested that oxycodone offered a favorable balance between analgesic efficacy and hemodynamic stability,making it a safer alternative for postoperative pain management in patients at cardiovascular risk.展开更多
BACKGROUND Chest physiotherapy and incentive spirometry,essential for pulmonary care,can exacerbate acute post-thoracotomy pain.Pain relief is,therefore,essential to facilitate early mobilization.This study evaluated ...BACKGROUND Chest physiotherapy and incentive spirometry,essential for pulmonary care,can exacerbate acute post-thoracotomy pain.Pain relief is,therefore,essential to facilitate early mobilization.This study evaluated the analgesic efficacy of unilateral continuous erector spinae block(ESB)compared to thoracic epidural analgesia(TEA)in terms of quality of pain relief and perioperative hemodynamic changes.AIM To compare the analgesic efficacy of continuous ultrasound-guided unilateral ESB and thoracic epidural in patients undergoing antero-lateral thoracotomy.METHODS This prospective,observational study was conducted at a tertiary care hospital of central India.Sixty-eight adult patients of either gender,posted for elective thoracic surgeries requiring one lung ventilation,were allocated to either TEA(n=34)or ESB(n=34)group,based on the attending anesthesiologist’s expertise.Continuous data were analyzed by independent t-tests,and categorical data byχ2 tests.RESULTS The proportion of patients requiring rescue opioids within 24 hours post-extubation was similar between the two group.Resting numerical rating scale scores(0 hour,6 hours,and 72 hours post-extubation)were significantly higher in the ESB group compared to the TEA group[1.70±1.03 vs 1.05±0.77(P=0.004);1.64±0.98 vs 1.2±0.88(P=0.05);3.2±1.07 vs 2.61±0.92(P=0.013)].Dynamic numerical rating scale scores and post-extubation mean arterial pressures were also higher in the ESB group.Additionally,block performance time was significantly longer in the ESB group(16.58±3.66 vs 13.84±2.88,P=0.001).CONCLUSION The two techniques provided similar opioid-sparing effects following antero-lateral thoracotomy,though TEA exhibited a superior analgesic efficacy at the expense of increased hemodynamic instability requiring vasopressor support.展开更多
To introduce the experience of professor JIA Chun-sheng in rapid analgesia and motor function rehabilitation by subcutaneous penetration needling of auricular acupuncture.Subcutaneous penetration needling of auricular...To introduce the experience of professor JIA Chun-sheng in rapid analgesia and motor function rehabilitation by subcutaneous penetration needling of auricular acupuncture.Subcutaneous penetration needling of auricular acupuncture plays a role in rapid analgesia and motor function rehabilitation in treatment of pain in limbs and trunk and/or limb dysfunction caused by migraine,cervical spondylosis,acute lumbar sprain,soft tissue injury,scapulohumeral periarthritis,lumbar disc herniation,sciatica,stroke or cerebral trauma,and it is worthy of being widely promoted and applied clinically.展开更多
Objective: To evaluate the effect of test dose fentanyl on predictingpostoperative analgesia and respiratory depression. Methods: Preoperatively the lowest pulseoximeter saturation (SpO_2) under room air breathing was...Objective: To evaluate the effect of test dose fentanyl on predictingpostoperative analgesia and respiratory depression. Methods: Preoperatively the lowest pulseoximeter saturation (SpO_2) under room air breathing was measured after 2 μg/kg of fentanyl givenintravenously in 35 patients who were scheduled with continuous intravenous morphine analgesia (12μg·kg^(-1)·h^(-1)) postoperatively. Results: The test dose fentanyl resulted in respiratorydepression in 19 of 35 cases, while 8 (42.1%) of the 19 cases developed respiratory depressionpostoperatively. However in the rest 16 patients, no patient (0) developed respiratory depression (P< 0.01). The fentanyl-induced lowest SpO_2 significantly correlated with the lowest SpO_2postoperatively (P < 0.01). The analgesia effect in terms of verbal analogue scale was correlatedneither with the fentanyl-induced lowest SpO_2 nor with the lowest SpO_2 postoperatively (P > 0.05).Conclusion: The patient who was sensitive to fentanyl-induced respiratory depression would take ahigh risk to develop postoperative respiratory depression with intravenous morphine analgesia andthe patient with respiratory depression does not always go with satisfactory analgesia.展开更多
文摘BACKGROUND Gastric cancer(GC)is a prevalent tumor in the digestive system,with around one million new cases reported annually,ranking it as the third most common malignancy.Reducing pain is a key research focus.This study evaluates the effect of nalbuphine on the analgesic effect and the expression of pain factors in patients after radical resection.AIM To provide a reference for postoperative analgesia methods.METHODS One hundred eight patients with GC,admitted between January 2022 and June 2024,underwent radical gastrectomy.They received a controlled analgesia pump and a transverse abdominis muscle plane block,divided into two groups of 54 patients in each group.The control group received sufentanil,while the observation group received nalbuphine as an analgesic.Postoperative analgesic effects,pain factor expression,and adverse effects were compared.RESULTS The resting pain and activity pain scores in the observation group at 6,12,24 and 48 hours were significantly lower than those in the control group.Additionally,the number of presses and consumption of the observation group at 48 hours were lower than those of the control group;and the response rate of the observation group was higher than that of the control group(P<0.05).The prostaglandin E2,substance P,and serotonin levels 24 hours after the observation group were lower than those in the control group,and the incidence of adverse reactions was 5.56%lower than 22.22%in the control group(P<0.05).CONCLUSION The findings suggest that nalbuphine enhances postoperative multimodal analgesia in patients with radical GC,effectively improving postoperative analgesic effect,relieving postoperative resting and active pain,and reducing postoperative pain factor expression,demonstrating its potential for clinical application.
基金The National Natural Science Foundation of China(Project No.:82172036)Undergraduate teaching quality and teaching reform cultivation project of the First Affiliated Hospital of Sun Yat-sen University in 2023(Project No.P12220011-230106)。
文摘Objective:To evaluate the analgesic effect and safety of hydromorphone hydrochloride in PCIA combined with flurbiprofen axetil and pre-emptive analgesia in patients with TACE treatment for hepatocellular carcinoma.Methods:Backward observation was made on 90 patients with advanced liver carcinoma who performed TACE treatment in the First Affiliated Hospital of Sun Yat-sen University from January 2022 to October 2023,dividing them into Group A(continuous pump injection of 6 mg hydromorphone+50mg flurbiprofen ester as background injection for 2 ml/h,additional single injection of 3 ml/10min,15 minutes before surgery)and Group B(intravenous injection of 50 mg flurbiprofen ester during the operation,additional injection of tramadol 100 mg intramuscular injection if necessary).Groups were compared and analyzed at different time points in surgery and post-operation time from pain level(NRS),side effects,inflammatory indexes(PCT,IL-6),satisfaction rate.Result:NRS scores at 5 time points,during operation,immediately post-surgery,12,24 hours post-operation,Group A were significantly lower than Group B(Group A during operation 3.0,immediate postoperation 3.0 to 24h 1.0;Group 4.0 to 24h 1.0,all P>0.05).The rate of adverse reactions were comparable between the two groups(all P>0.05).The amount of PCT(0.23 ng/ml vs 1.15 ng/ml)and IL-6(54.49 pg/ml vs 233.49 pg/ml)decreased post-surgery in Group A compared to Group B,but were not statistically significant difference(P=0.424/P=0.502),and more patients in Group A were relieved to grade score of pain relief 4 or above(86.7%vs.60%,P=0.001).Conclusions:Pre-emptive analgesia treatment using PCIA of hydromorphone hydrochloride combined with flurbiprofen axetil has better analgesic effect than routine analgesic therapy in postoperative care of mid to advanced hepatocellular carcinoma TACE,has good safety,and is worth of further promotion and verifying.
文摘Objective:To investigate the application effect of dexmedetomidine in anesthesia for thyroid cancer(TC)surgery.Methods:A total of 90 patients admitted to our hospital from January 2023 to December 2023 were selected as the study subjects.The patients were divided into an observation group(given continuous intravenous infusion of dexmedetomidine during surgery)and a control group(given continuous intravenous infusion of an equal volume of sodium chloride injection during surgery)by lottery method,and the anesthesia indicators of the two groups were compared.Results:The dosages of remifentanil and propofol in the observation group were lower than those in the control group(p<0.05);the incidence of complications in the observation group was lower than that in the control group(p<0.05);the Visual Analogue Scale(VAS)scores of the observation group at 4 h,12 h,24 h,and 48 h postoperatively,both at rest and during activity,were lower than those of the control group(p<0.05).Conclusion:During surgery for TC patients,continuous intravenous infusion of dexmedetomidine can reduce the dosage of anesthetic drugs and the incidence of anesthesia-related complications,alleviate postoperative pain,and is worthy of promotion and application.
基金funded by Beijing National Science Foundation(No.7222289)the CACMS Innovation Fund(No.CI2021A03404)the Fundamental Research Funds for the Central Public Welfare Research Institutes(No.ZZ2023002).
文摘The significance of glial cells in the nervous system,particularly in the modulation of pain,has increasingly gained prominence,thereby shifting the traditional neurobiological research paradigm that predominantly focused on neurons.Acupuncture treatment have been shown to influence the functionality of glial cells,enabling them to serve as modulators that significantly contribute to the inhibition of neurogenic inflammation,the restoration of synaptic homeostasis,and the enhancement of the pain modulation system.Furthermore,various molecules and their associated signaling pathways facilitate the biological effects of glial cells in the context of acupuncture-induced analgesia.Notably,P2X receptors(P2X3,P2X4,and P2X7),the MAPK pathway(including p38MAPK and ERK),and the JAK/STAT pathway within glial cells are implicated in the modulation of neuroinflammation and pain regulation through acupuncture.These elucidated mechanisms underscore the potential of acupuncture to modulate neuroimmune signaling for pain alleviation and suggest the prospect of developing more targeted and effective treatments for chronic pain in the future.
文摘BACKGROUND Patients who undergo cardiac surgery often face postoperative pain and potential cognitive issues.Multimodal analgesia may address these problems.We hypothesized that multimodal analgesia can reduce opioid use and improve cognitive recovery.AIM To investigate the effects of multimodal analgesia on postoperative opioid consumption and cognitive recovery in patients who underwent cardiac surgery.METHODS A prospective,randomized controlled trial at General Hospital from January 2020 to April 2023 recruited a total of 150 adult patients who underwent elective cardiac surgery.The patients were randomly divided into two groups.Group A had patient-controlled intravenous analgesia with sufentanil and flurbiprofen axil.Group B had flurbiprofen axil and paravertebral nerve block.Data were analyzed with appropriate statistical methods.RESULTS Group B had lower postoperative patient-controlled intravenous analgesia drug consumption(2.21 mL/hour vs 4.26 mL/hour,P<0.001),shorter extubation time(2.32 hours vs 3.81 hours,P<0.001),and intensive care unit stay(15.32 h vs 28.63 h,P<0.001).Visual Analogue Scale pain scores were lower in group B(P<0.001).Group B had fewer postoperative complications(no respiratory depression vs 37.9%in group A,P<0.05),a lower postoperative cognitive dysfunction incidence(16.0%vs 28.0%,P<0.05),and higher Barthel Index scores(P<0.05).CONCLUSION Multimodal analgesia with paravertebral nerve block and flurbiprofen axil reduces opioid use and improves cognitive outcomes in patients who underwent cardiac surgery.
基金supported by the Health and Health Development Promotion Project-Anesthesia and Critical Care Research Project(No.KM-20240219-01)。
文摘Background Postoperative pain,if not effectively controlled,can trigger sympathetic activation and stress responses that increase the risk of cardiovascular complications.Oxycodone,a semisynthetic opioid acting on bothμ-andκ-receptors,may provide stable analgesia with less hemodynamic fluctuation compared with the pureμ-agonist sufentanil.This study aimed to compare the efficacy and cardiovascular safety of oxycodone-based versus sufent anil-based intravenous patient-controlled analgesia(IV-PCA)after laparoscopic abdominal surgery.Methods This single-center retrospective comparative study included patients who underwent laparoscopic abdominal surgery between March 2024 and March 2025.According to their postoperative PCA regimen,patients were divided into an oxycodone group and a sufentanil group.The primary endpoint was the incidence of cardiovascular adverse events(CVAE)within 48 h after surgery,including hypotension,bradycardia,and arrhythmia.Logistic regression was used to identify independent predictors of CVAE,and receiver operating characteristic(ROC)analysis assessed discriminative performance.Results A total of 356 patients were analyzed(oxycodone n=197;sufentanil n=159).The incidence of CVAE was significantly lower in the oxycodone group than in the sufentanil group(5.2%vs.12.1%,P=0.021).Oxycodone provided comparable analgesic intensity with fewer PCA bolus attempts(36±15 vs.52±17,P<0.001)and higher patient satisfaction scores(4.3±0.5 vs.4.1±0.5,P=0.002).Multivariate logistic regression identified sufentanil use(OR:2.53,95%CI:1.16-5.84,P=0.018)as independent predictors of CVAE.Conclusions Oxycodone-based IV-PCA provided effective postoperative analgesia with a lower incidence of cardiovascular adverse events compared with sufentanil-based PCA.The results suggested that oxycodone offered a favorable balance between analgesic efficacy and hemodynamic stability,making it a safer alternative for postoperative pain management in patients at cardiovascular risk.
文摘BACKGROUND Chest physiotherapy and incentive spirometry,essential for pulmonary care,can exacerbate acute post-thoracotomy pain.Pain relief is,therefore,essential to facilitate early mobilization.This study evaluated the analgesic efficacy of unilateral continuous erector spinae block(ESB)compared to thoracic epidural analgesia(TEA)in terms of quality of pain relief and perioperative hemodynamic changes.AIM To compare the analgesic efficacy of continuous ultrasound-guided unilateral ESB and thoracic epidural in patients undergoing antero-lateral thoracotomy.METHODS This prospective,observational study was conducted at a tertiary care hospital of central India.Sixty-eight adult patients of either gender,posted for elective thoracic surgeries requiring one lung ventilation,were allocated to either TEA(n=34)or ESB(n=34)group,based on the attending anesthesiologist’s expertise.Continuous data were analyzed by independent t-tests,and categorical data byχ2 tests.RESULTS The proportion of patients requiring rescue opioids within 24 hours post-extubation was similar between the two group.Resting numerical rating scale scores(0 hour,6 hours,and 72 hours post-extubation)were significantly higher in the ESB group compared to the TEA group[1.70±1.03 vs 1.05±0.77(P=0.004);1.64±0.98 vs 1.2±0.88(P=0.05);3.2±1.07 vs 2.61±0.92(P=0.013)].Dynamic numerical rating scale scores and post-extubation mean arterial pressures were also higher in the ESB group.Additionally,block performance time was significantly longer in the ESB group(16.58±3.66 vs 13.84±2.88,P=0.001).CONCLUSION The two techniques provided similar opioid-sparing effects following antero-lateral thoracotomy,though TEA exhibited a superior analgesic efficacy at the expense of increased hemodynamic instability requiring vasopressor support.
文摘To introduce the experience of professor JIA Chun-sheng in rapid analgesia and motor function rehabilitation by subcutaneous penetration needling of auricular acupuncture.Subcutaneous penetration needling of auricular acupuncture plays a role in rapid analgesia and motor function rehabilitation in treatment of pain in limbs and trunk and/or limb dysfunction caused by migraine,cervical spondylosis,acute lumbar sprain,soft tissue injury,scapulohumeral periarthritis,lumbar disc herniation,sciatica,stroke or cerebral trauma,and it is worthy of being widely promoted and applied clinically.
文摘Objective: To evaluate the effect of test dose fentanyl on predictingpostoperative analgesia and respiratory depression. Methods: Preoperatively the lowest pulseoximeter saturation (SpO_2) under room air breathing was measured after 2 μg/kg of fentanyl givenintravenously in 35 patients who were scheduled with continuous intravenous morphine analgesia (12μg·kg^(-1)·h^(-1)) postoperatively. Results: The test dose fentanyl resulted in respiratorydepression in 19 of 35 cases, while 8 (42.1%) of the 19 cases developed respiratory depressionpostoperatively. However in the rest 16 patients, no patient (0) developed respiratory depression (P< 0.01). The fentanyl-induced lowest SpO_2 significantly correlated with the lowest SpO_2postoperatively (P < 0.01). The analgesia effect in terms of verbal analogue scale was correlatedneither with the fentanyl-induced lowest SpO_2 nor with the lowest SpO_2 postoperatively (P > 0.05).Conclusion: The patient who was sensitive to fentanyl-induced respiratory depression would take ahigh risk to develop postoperative respiratory depression with intravenous morphine analgesia andthe patient with respiratory depression does not always go with satisfactory analgesia.
