Sufentanil For Patient-controlled Subcutaneous Analgesia After Artificial Joint Replacement In Clinical Observation

Objective: 1. Evaluation of the Analgesic effect in the Subcutaneous analgesia and intravenous analgesia after artificial joint replacement surgery; 2. Evaluation of the Analgesic effect with different doses sufentanil in the subcutaneous self-control analgesia after artificial joint replacement.Methods: 120 patients who received joint replacement was randomly divided into six groups after operation, including PCSA group: 20 cases of S1 group(sufentanil 3.0 μg/kg), 20 cases of S2 group(sufentanil 3.5 μg/kg), 20 cases of S3 group(sufentanil 4.0 μg/kg), PCIA group: 20 cases of I1 group(sufentanil 3.0 μg/kg), 20 cases of I2 group(sufentanil 3.5 μg/kg), 20 cases of I3 group(sufentanil 4.0μg/kg). Respectively connecting PCA pump in subcutaneous and intravenous. PCA pump Setting:analgesic liquid of sufentanil 3.0 ~ 4.0 μg/kg + saline to 100 ml, Maintain 48 hours of postoperative analgesia, Controls time locked 15 min, Controlled liquid 0.5ml/times. Observe and record the pain, nausea,vomiting and skin pruritus in postoperative 4 h, 8 h, 12 h, 24 h, 36 h and 48 h six period.Results: 1. NRS scores:(1) comparison between groups: compared with S1 group, the NRS scores in S2 group and S3 group were lower at each time; compared with I1 group, the NRS scores in I2 group and I3 group were lower at each time, the difference was statistically significant(P < 0.05). the NRS scores in S3 group and I3 group were lower than S2 group and I2 group at the time of 4 h and 8 h, the difference was statistically significant(P < 0.05).(2)Group comparison: compared with 4 h, the NRS scores in I3 group, S3 group at the time of 8 h were higher, compared with 12 h, the NRS scores in S1 group, I1 group at the time of 24 h were lower, compared with 24 h, the NRS scores in I1 group at the time of 36 h were lower, the difference was statistically significant(P < 0.05). 2. Ramsay scores :(1) comparison between groups:compared with S1 group, the Ramsay scores in S2 group and S3 group were higher at the time of 4 h, 8 h, 12 h, compared with I1 group, the Ramsay scores in I2 group and I3 group were higher at the time of 4 h, 8 h,12 h, the difference was statistically significant(P < 0.05).(2)Group comparison: compared with 24 h, the Ramsay scores in I1 group at the time of 36 h were higher, compared with 36 h, the Ramsay scores in I1 group at the time of 48 h were higher, the difference was statistically significant(P < 0.05); The rest of the group compared with the previous time, there was no statistically significant difference(P > 0.05). 3.Adverse reactions:(1) nausea situation: compared with S3 group, S1 group and S2 group have more people nausea, the difference was statistically significant(P < 0.05);(2) vomiting situation: compared with S3 group, S1 group and I3 group have more people vomiting, the difference was statistically significant(P <0.05);(3) cases of pruritus: comparison between S group and I group, there was no statistically significant difference(P > 0.05).Conclusion: 4.0 μg/kg of sufentanil for Patient-controlled Subcutaneous Analgesia after elderly artificial joint replacement, can achieve satisfactory postoperative analgesia effect.