Clinical Observation Of Sufentanil Combined With Tramadol For Patient Controlled Intravenous Analgesia After Thoracotomy

Objective: To explore the efficiency of Sufentanil combined with Tramadol in Patient controlled intravenous analgesia after thoracotomy. To search for a better method in Patient controlled intravenous analgesia by using sufentanil alone , tramadol alone or sufentanil combined with tramadol . To diminish and minimize the side effect of the analgesics and to improve the quality of postoperative analgesia for patients undergoing thoracotomy.Methods: Sixty ASA I-II patients scheduled for thoracotomy were selected with the age of 20-55 years and weight of 45-75kg, without electrolyte disturbance, drug abusing history (especially opiums), allergy to any drugs or history of treating with opiums for chronical pain. The patients were randomly divided into three groups (twenty cases in each group). Group S: Sufentanil 0.04μg/kg·h +Ondansetron 8mg; Group T: Tramadol 0.4mg/kg·h+Ondansetron 8mg; Group ST: Sufentanil 0.03μg/kg·h+Tramadol 0.2mg/kg·h+Ondansetron 8mg. PCIA included background 2ml/h and bolus of 0.5 m1 with a lockout-time 15 minutes. The loading doses were sufentanil 0.01μg/kg in Group S, and tramadol 2mg/kg in Group T and ST. The effect of postoperative analgesia was assessed byrecording visual analog scale (VAS) , sedation analog scales , nausea and vomitting scales at 4h, 8h, 16h, 24h, 48h separately after operation, as well as pulse oxygen saturation (SpO2), blood pressure(BP), heart rate(HR), breath rate(BR), the consumed dosage of the analgesics and also the ratio of actual controlled times and effective controlled times.Result: Visual analog scales were significantly higher in the Group T than the Group S and Group ST at 4h, 8h, 16h, 24h, 48h (P<0.05).There was no difference between Group S and group ST. Compared with Group S and Group ST, there was more total analgesic consumption in Group T at 16h and 24h (P<0.05). The total proportion of controlled times was obviously more at 16h, in the Group T than that in Group S and Group ST (P<0.05). Seventeen patients experienced nausea and eight vomited in the Group T. In Group S and ST, three patients experienced nausea and no one vomited. In all three groups, the vital sign was stable . And there was no significant difference .Conclusion: These results suggest that compared with Tramadol 0.4mg/kg·h, Sufentail 0.04μg/kg·h and Sufentail 0.03μg/kg·h +tramadol 0.2mg/kg·h are safer and more effective for PCIA after thoracotomy.