Efficacy Of PCSA With Combined Sufentanil And Lornoxicam In Abdominal Surgery

BackgroundSufentanil is a new potent opioid drug, which has been widely used in postoperative analgesia. Lornoxicam is a new class of non-steroidal anti-inflammatory drug (NSAIDs) that has strong anti-inflammatory analgesic effects, and plays a key role in multimodality analgesia with opioid combination. Literatures about sufentanil used by patient controlled subcutaneous analgesia(PCSA) is relatively rare.It is known that PCSA can reduce the risks about the related complications induced by epidural analgesia and intravenous analgesia catheter, advantages of PCSA including simple, convenient and flexible, and it's analgesic effect is stable, durable, reliable and safe. The inhibition of inflammatory response and analgesic effects, which sufentanil combined with lornoxicam used by PCSA after abdominal surgery, is also worth exploring. This study was aimed to explore efficacy of PCSA with different doses of sufentanil combined with lornoxicam after abdominal surgery, determine the effective clinical compatibility program with low risk of side effects, and provide a reference for clinical application.ObjectiveThrough observing the effects of different doses of sufentanil combined with lornoxicam used by PCSA after abdominal surgery, and detecting serum IL-6,β-endorphin of the different time points, this study will receive a comprehensive evaluation, and also explore an appropriate PCSA compatibility program with sufentanil after operation.Methods 80 ASAⅠ-Ⅱpatients scheduled abdominal surgeries under general anesthesia, aged 25-65 years old, weighing 45-75 kg were randomly divided into 4 groups:Group F (Fentanyl 1 mg+LOR 32 mg), Group S1 (Sufentanil 75 u g +LOR 32 mg), Group S2 (Sufentanil 100 u g+LOR 32 mg), Group S3 (Sufentanil 125μg+LOR 32 mg). PCA pumps are used to set the background dose of 2 ml/h, controlled dosage of 0.5 ml, lockout time 15 min. Pain scores, sedation scores and adverse reactions of postoperative 2 h,6 h,12 h,24 h,48 h were recorded, the serum IL-6 andβ-endorphin levels of preoperative and 6h,24 h after the operation were detected. With the cases of baseline information, the SPSS 17.0 statistical software was used to perform the analysis, and obtain the final conclusion.ResultsThere was no significant difference about basic information, intraoperative medication and amount of intake and output among the four groups(P>0.05). Preoperative and postoperative vital signs, except for a few slightly different in the individual time points (P<0.05), there was no significant difference (P>0.05). The postoperative level of the IL-6 andβ-endorphin were significantly increased substantially in the four groups than the preoperative level, group S1> group F> group S2> group S3(P<0.05), and level of 24h was lower than 6h. The VAS score of postoperative 6h was significantly higher than 2h in four groups(P<0.05), and the score of this two time points was higher than the other points, then gradually decreased, but overall group S1> group F> group S2> group S3(P<0.05). No significant difference in postoperative adverse events (P>0.05), but excessive doses of sufentanil combined with lornoxicam can take a slightly higher incidence of nausea, vomiting.ConclusionPCSA with 100μg/48h sufentanil combined lornoxicam can be appropriately reduced IL-6 andβ-endorphin levels after abdominal surgery, provides satisfied analgesic effects, without increasing the occurance of side effects. Sufentanil may increase the nausea, vomiting incidence if overdosage used, low-dosage used makes the insufficient analgesia.