The Clinical Recherch Of Postoperative Analgesia With Patientcontrolled- Target Controlled Infusion Of Sufentanil After Gynecological Laparoscopic Surgery

Objective To investigate the efficacy and safety of sufentanil controlled target-controlled infusion techniques (PCA-TCI) Analgesia pump after laparoscopic gynecological surgery by the guide of Tivatrainer pharmacokinetic simulation software.Methods 36 patients with ASAI-II undergoing Laparoscopic gynecologic surgery use SPSS randomly divided into PCA-TCI control group (A) and target control group (B), each group of 18 patients. During the surgery patients in both groups with target controlled infusion of sufentanil and propofol. We using Tivatainer pharmacokinetic software to simulate the patients’plasma drug concentration of sufentanil, when the target plasma concentration achieved CpO.lng/ml (To) start the analgesia pump. At the following analgesia time points To(0),T1 (30min), T2 (1h), T3 (2h), T4 (4h), T5 (6h), T6 (8h), T7 (16h), recording Prince-Henry pain score, Ramsay score, life signs and pressing times, each time segment sufentanil dose and the occurrence of adverse reactions and analysis the blood gas at the time point of To,T2,T4,T6, made of sufentanil target plasma concentration of the corresponding values at each time point.Results:(1) The general information of two groups is the same, no statistical difference. (2) MAP, HR, RR, SpO2, nasal PetCO2 and blood gas values were in the normal range in both groups at the different time points. (3) The Prince-Henry pain score and Ramsay sedation score in two groups has no significant statistical. (4) In group A the using dose of sufentanil was significantly lower than group B at the each time points during the 16 hours analgesia, it has significance statistical. (5) The target concentration of sufentanil in the two groups were different, which has a statistically significant (P>0.05). Patients with target concentration of A group was lower than in B group, the effective concentration in the A group was 0.07±0.03ng/ml. (6) In the process of analgesia, the patients in two groups with no adverse reactions, inadequate analgesia, respiratory depression, nausea and vomiting.Conclusion:In gynecological laparoscopic surgery postoperative analgesia, PCA-TCI and TCI analgesia is the same, both can achieve satisfactory clinical analgesic effect. While using the PCA-TCI can significantly reduce sufentanil using dosage, utmostly meet the individual on-demand delivery principle.