CAJ | 학술논문

目的：比较不同位置皮下给予舒芬太尼在术后皮下自控镇痛(PCSA)中的临床效果和安全性。方法选择1000例术后行PCSA患者随机分为前臂组(A组)和三角肌组(B组)，每组各500例，PCSA设置：无负荷量、维持量1.0~2.5 ml/h、追加量0.5~1.5 ml/h、PCA时间10 min、维持48 h。记录术后6、12、24、48 h的VAS、Ramsay评分、不良反应发生情况及留置针情况。结果两组患者的镇痛效果及不良反应发生率差异均无统计学意义(P>0.05)；两组留置针脱落率差异有统计学意义(P<0.05)。结论前臂法和三角肌法舒芬太尼PCSA同样安全有效，但发生前臂给药留置针脱落的情况明显较少，可减少回访压力，减少医患纠纷，更适合临床使用。
목적：비교불동위치피하급여서분태니재술후피하자공진통(PCSA)중적림상효과화안전성。방법선택1000례술후행PCSA환자수궤분위전비조(A조)화삼각기조(B조)，매조각500례，PCSA설치：무부하량、유지량1.0~2.5 ml/h、추가량0.5~1.5 ml/h、PCA시간10 min、유지48 h。기록술후6、12、24、48 h적VAS、Ramsay평분、불량반응발생정황급류치침정황。결과량조환자적진통효과급불량반응발생솔차이균무통계학의의(P>0.05)；량조류치침탈락솔차이유통계학의의(P<0.05)。결론전비법화삼각기법서분태니PCSA동양안전유효，단발생전비급약류치침탈락적정황명현교소，가감소회방압력，감소의환규분，경괄합림상사용。
Objective To compare the clinical effects and safety of the subcutaneous administration of sufentanil at dif-ferent locations in the postoperative PCSA. Methods 1000 patients receiving postoperative PCSA were selected and randomly divided into the forearm group (group A) and the deltoid group (group B),with 500 cases in each group.The PCSA settings were no load,maintaining dose of 1.0-2.5 ml/h,additional dose of 0.5-1.5 ml/h,PCA time of 10 minutes and maintaining 48 hours.The postoperative 6,12,24 and 48-hour VAS,Ramsay scores,adverse reactions and remaining needle conditions were recorded. Results The two groups were not statistically different in the analgesic effects and in-cidence of adverse reactions (P>0.05).The two groups were significantly different in the fall rate of remaining needle, with statistical significance (P<0.05). Conclusion Both forearm and deltoid administration of sufentanil is safe and ef-fective,but forearm administration shows less remaining needle fall,can reduce return visit pressure and reduces medical dispute,which is suitable for clinical use.