Efficacy of sufentanil and Iornoxicam combination in patient controlled intravenous analgesia after abdominal surgery

Abstract

Objective To investigate the efficacy of sufentanil combined with lornoxicam for patient controlled intravenous analgesia （PCIA） after abdominal surgery. Methods A total of 80 patients in ASA I or II underwent elective abdominal surgery under general anesthesia between November 2007 and October 2009 in the Affiliated Tumor Hospital, Guangzhou Medical College. All of their anesthesia regimens followed propofol ＋ remifentanil for intravenous pumping and sevoflurane for inhalation. Patients were randomly divided into 4 groups for PCIA after operation （n=20）： sufentanil 50μg ＋ lornoxicam 32 mg in group SI, sufentanil 100 μg ＋ lornoxieam 32 mg in group S2, sufentanil 150 μg ＋ lornoxieam 32 mg in group S3, fentanyl 1 mg ＋ lornoxieam 32 mg in group F. Drugs in eaeh group were diluted with normal saline to 100 ml. Graseby 9500 PCA pump was used in a mode of loading dose at 5 ml＋baekground infusion at 1 ml/h＋PCA at 2 ml, with lockout interval at l0 minutes. We recorded analgesia scales and sedation scores at postoperative 1 h （T1）, 2 h （T2）, 4 h （T3）, 8 h （T4）, 16 h （T5）, 24 h（T6） and 48 h （T7）, and so were the total times of pressing PCA pump （D1） and effective drug-intake times （DE） , adverse reactions such as nausea and vomiting during the first 48 hours after operation. The overall patient satisfaction with PCA was evaluated. Results The analgesia scales during rest and moving were as follows： At T2, T3 and T4, group S2 [ （1.5±0.6, 1.6±0.8, 1.5±0.9）, （2.1±1.2, 2.0±1.3, 2.1±0.9） ] and group $3 [ （1.4±0.6, 1.5±0.7, 1.6±0.8）, （ 1.9±0.9, 2.1±1.0, 2.0±1.1 ） ]. Both of their scales were significantly lower than those of group F [ （2.0±0.8, 2.1±0.9, 2.1±0.8）, （2.7±1.0, 2.7±1.2, 2.8±1.2）] at T2, T3, T4（P〈0.05）. At T3 and T4, analgesia scales of group $1 [ （2.7±1.2, 2.8±1.3）, （3.4±1.5, 3.5±1.4） ] were significantly higher than those of group F （P〈 0.05）. The sedation scores at T3 and T4 in group $3 （2.3±0.2, 2.5±0.3） were dramatically higher than group F （2.0±0.0, 2.1±0.0, P〈0.05）. The DI （12.5±7.5） and D2 （9.6±6.3） of group S1 were higher than those of group F （8.5±5.2, 6.2±2.7, P〈0.05）. The incidences of nausea and vomiting in group $1 （5.0%） and group $2 （10.0%） were lower than group F （20.0%, P〈O.05） ）. Cases whose overall patient satisfaction of PCA was ranking good in group $1 were less than group F （P〈0.05）. Conclusion By PCIA with 1 mg/L sufentanil combined with lornoxicam, good analgesic effect and less adverse effects may be achieved. Key words: Sufentanil; Lornoxicam; Analgesia, patient - controlled; Infusions, intravenous; Abdomen