关键词: 药效学, 芬太尼, 镇痛, 静脉内, 硬膜外, 疗效评价

Abstract: AIM: To evaluate the efficacy and safety ofPatient-controlled analgesia (PCA)of intravenous or epidural fentanyl.METHODS: 40Patients undergoing elective hysterectomy were randomly allocated toPatient-controlled intravenous analgesia (PCIA)grouP(n =20)andPatient-controlled epidural analgesia (PCEA)group(n =20).ThePCA solution consisted of fentanyl 1 000μg,droperidol 5mg and NS 78 ml,loading dose of fenta-nyl 50μg,background infusion 1 ml·h^-1,bolus 1 ml,andlockout time 15 min.The scores ofPain and seda-tion,the number ofPCA demand and delivery,fentanyl consumption,side effects andPatient' s satisfaction were assessed for 48 hours.RESULTS: The total dosage of fentanyl used,the number ofPCA demand and delivery in 48 hours were obviously smaller inPCIA grouPthan inPCEA grouP(P<0.05).Two groups gained satisfactoryPain relief and sedation,but during 12 hours afterPCAPumpswere used,significant differences were found be-tween two groups on VAS and Ramesay sedation scores(P<0.05).There was no marked difference on side ef-fects between two groups.The overall satisfaction of thePatients in two groups aboutPostoperative analgesia was 90%inPCIA and 85% inPCEA,respectively.CON-CLUSION: Fentanyl forPostoperativePain relief is a safe and effective agent,butPCIA with fentanyl is better thanPCEA with fentanyl forPostoperative analgesia.

Key words: pharmacodynamics, fentanyl, analge-sia, intravenous, epidural, efficacy evaluation