Clinical Observation Of Sufentanil Dosage During PACU After LC Operation In Yi Nationality And Han Nationality In Yuxi City

Objectives:The clinical analgesic effect of sufentanil dosage during PACU after laparoscopic cholecystectomy was prospectively observed between Yi nationality and Han nationality in Yuxi area of Yunnan Province.and explore the reasons for the difference in the analgesic effect of opioids between the two ethnic groups.Provide a pre-clinical basis for the individualized use of opioids in the Yi and Han populations in Yuxi,Yunnan.Methods:From July 2019 to December 2020,254 cases of endoscopic cholecystectomy in Yuxi City People’s Hospital and Eshan County People’s Hospital in Yunnan Province were included prospectively.The patients were divided into Yi nationality group(Y group,n=127)And Han nationality group(H group,n=127).Induction of anesthesia,intravenous injection of sufentanil 0.4ug/kg,propofol 2mg/kg,vecuronium 0.1mg/kg,intubation after muscle relaxation is satisfied,During the operation,adjust the pumping speed of propofol and remifentanil to maintain the depth of anesthesia,so that the BIS(Bispectral Index)value is maintained between 45-60.When the abdomen is deflated after laparoscopic surgery,Preventive analgesia by intravenous injection of sufentanil 0.1ug/kg.Stop the pump injection of propofol 5 minutes before the end of the skin suture,and stop the pump injection of remifentanil after the skin suture is over.After the patient is awake and smoothly extubated,he is sent to the postanesthesia care unit.After the patients entered the PACU(Postanesthesia Care Unit),the analgesic intervention needs and safety of the two groups were observed.Sufentanil 0.05ug/kg/time is added to patients with VAS(Visual Analogue Score)≥4 points until satisfactory analgesia is achieved.When VAS<4 points and Steward score≥4 points,the patient can be sent back to the ward.Record the MBP(Mean Arterial Blood Pressure)and HR(Heart Rate)of the two groups of patients after entering the operating room(T0),before tracheal intubation(T1),after tracheal intubation(T2),after pneumoperitoneum(T3),when the gallbladder was removed(T4),at the end of the operation(T5).Record the use of propofol,remifentanil,vasoactive drugs and other drugs during the operation,and record the time from drug withdrawal to wakefulness and the time from drug withdrawal to extubation.Record the patient’s maximum pain score in the PACU,the frequency and dose of sufentanil supplementation in the PACU;observe the adverse reactions of the two groups of patients in the PACU:including nausea and vomiting,respiratory depression,skin pruritus and other opioid adverse reactions.Record the stay time of PACU:more than 60 minutes is an extension of the stay time,the reasons include insufficiency of analgesia or opioid adverse reactions.Results:1.There was no difference in general information and anesthesia time between the two groups(P>0.05).2.Comparison between groups:There is no difference in basal blood pressure and heart rate between the two groups after entering the operating room(T0)(P>0.05).The MBP of group Y at T1 is higher than that of group H,and the HR of group Y is higher than that of group H at T2,Statistically significant(P<0.05).Comparing the hemodynamic parameters of the same group at time T1-T5 with time T0,the MBP and HR at time T1-T5 of group H and Y decreased compared with time T0,and the difference was statistically significant(P<0.05).3.There was no statistically significant comparison of intraoperative propofol and remifentanil dosage between the two groups(P>0.05).4.There was no difference in the use rate of atropine,ephedrine and nicardipine between the two groups(P>0.05).5.There was no difference in the time from drug withdrawal to wakefulness and the time from extubation to extubation between the two groups(P>0.05).6.The maximum VAS pain score in group Y was higher than that in group H,the number of analgesic cases in group Y is greater than that in group H in the PACU(P<0.05).7.The number of patients in group H that required sufentanil analgesia intervention for 0 time and 1 times was more than that in group Y,while the number of patients in group Y that required sufentanil analgesia intervention for 3 times and 4 times was greater than that in group H,and the difference was statistically significant(P<0.05).8.The incidence of nausea and vomiting in the resuscitation room in group H is greater than that in group Y(P<0.05).9.The number of patients in group Y who prolonged the residence time of PACU greater than 60min due to pain was higher than that in group H,and the incidence of patients in group H who prolonged the residence time of PACU greater than 60min due to adverse reactions was higher than that in group Y,but the differences were not statistically significant(P>0.05).Conclusions:1.Patients of Yi nationality in Yunnan Province cannot tolerate early postoperative pain more than patients of Han nationality,and need more sufentanil analgesic intervention in the PACU.2.Compared with Yi patients,the incidence of opioid-related adverse reactions in Han patients has increased significantly,mainly manifested by the occurrence of nausea and vomiting The rate is high.3.Clinical sufentanil medication should consider the ethnic factors of the Yi and Han nationalities,and individualized medication.