Abstract
：Objective To evaluatethe efficacy of postoperative analgesia with sufentanil and its effects on stress responsein neonates.Methods Ninety ASAⅡ or Ⅲ neonates (age 1-30 d, weight 2.4-5.5 kg) undergoing abdominalsurgery including radical operation for megacolon were randomly divided into 3 groups ( n= 30 each): control group received normal saline ( N ) ;sufentanil group received ivinfusion of sufentanil at 0.03μg·kg~(-1)·h~(-1)(S) and fentanil group received iv infusion of fentanyl at 0.3μg·kg~(-1)·h~(-1) . Postoperative pain wasassessed and scored at the end of operation and at 4, 8, 12 and 24 h after operation basedon 5 criteria: (1) crying (0-2) : (2)O_2 inhalation is needed to maintain SaO_2 > 95%(0-2);(3) increase in BP and HR (0-2) ;(4) expression (0-2) and (5) sleeplessness (0-2).The results were rated as satisfactory analgesia 0-3;moderate pain 4-6 and severe pain7-10. Venous blood samples were taken before and at the end of operation and at 12 h and24 h after operation for determination of blood glucose level and serum cortisol andfi-endorphin concentrations. Results The 3 groups were comparable with respect to age,body weight, ASA physical status and duration of operation. The percentage of satisfactoryanalgesia was significantly higher in group S (90%) and F (80%) than in group N (40% ) .The blood glucose concentration was significantly increased at the end of operation ascompared with baseline before operation in all 3 groups and returned to baseline level at12 h after operation in group S, at 24 h after operation in group F but remained increasedin group N. There was no significant difference in serum cortisol and fi-endorphinconcentrations before and after operation in group S while in group F and N serum cortisollevel was significantly decreased and fi-endorphin level was significantly increased afteroperation as compared with the baseline before operation. Conclusion Postoperativeanalgesia with iv infusion of sufentanil provides adequate analgesia which can suppressstress response induced by postoperative pain. Key words: Sufentanil; Infant; newborn; Analgesia; Stress
Published Version
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