Clinical Study On Target Concentration Of Fentanyl For Postoperative Analgesia

Objective To study the fitting concentration of fentanyl for three different surgical sites, different age and genda on cancer patient postoperative analgesia by application of Tivatrainer software, and pravide clinical reference of fentanyl PCA-TCI therapy for the patient in this area.1.Clinical stdudy on target concentration of fentanyl used for postoperative analgesia for three different surgical siteObjective To study fitting target concentration of fentanyl analgesia on three different parts of the malignant tumors by the application of Tivatrainer software.Methods Ninety patients undergoing radical resection of malignant tumors were divided into three groups according to different surgical site: chest group (A), upper abdominal group (B), the ministry of pelvic group (C) (n=30).All patients from the beginning of anesthesia induction to extubation only used fentanyl as analgesia drugs. After extubation, record the time T when the Prince-Henry score at 3 under the Ramsay sedation score at level 2. Use Tivatrainer software to make the pharmacokinetic curve fitting based on the volume and time of fentanyl administration and then get the corresponding target concentration of fentanyl fitting at time T.Result On the mean fitting target concentration, Group A was higher than group B、C, there was significant difference between group A and group B(p<0.05), group A and group C was also significantly different (p<0.01); group B was higher than group C, group B and group C were different (p<0.05).Conclusion Postoperative pain intensity sorted by location from strong to weak:chest, upper abdominal, the ministry of pelvic; Fentanyl PCA-TCI target concentration for the start:the chest 1.04ng/ml, upper abdominal 0.94ng/ml, the ministry of pelvic 0.82ng/ml. 2.Clinical study on fentanyl target concentration of postoperative analgesia in cancer patients of different age and gender.Objective To study fentanyl target concentration of postoperative analgesia in cancer patients of different age and gender by the application of Tivatrainer software.Methods To study 120 cancer patients in department of thoracic hepatology、gestroenterology、urology、gynecology, all the patients were randomly divived into adult group (group A) and eldly group(group B), used fentanyl as long term analgesics only, According to the record, after extubation, record the time T when the prince-hurry score at 3 under Ramesay sedation score at 2 level.Make the drug metabolism curve by Tivatrainer software according to the dose and time of fentanyl administration, then get the fentanyl fitting target concentration at time T on the drug metabolism curve.Result On the fentanyl fitting target concentration of postoperative analgesia, adult people were higher than elderly people (p<0.05), men were higher than women in adult group (p<0.05) and no difference in eldly group; The 95%confidece interval of fentanyl fitting target concentration of postoperative analgesia in men、women and eldly people were 0.70-0.86ng/ml、0.78-1.00ng/ml、0.63-0.73 ng/ml respectly.Conclusion To the postoperative analgesia, adult people were lower than eldly people at pain threshold while women were lower than men.The fentanyl target concentration for PCA-TCI of men、women and eldly people could choose the dose of 0.70-0.86ng/ml、0.78-1.00ng/ml、0.63-0.73 ng/ml respectively.