Patient controlled intravenous analgesia for total hip arthroplasty:a comparison between sufentanil and fentanyl

Objective To compare the analgesic efficacy and complications between equivalent dose of sufen- tanil and fentanyl in patient controlled intravenous analgesia for total hip arthroplasty.Methods Sixty-one patients undergoing total hip arthroplasty were randomly divided into two groups:fentanyl 28μg/kg in F group(n=31) and sufentanil 2.8μg/kg in S group(n=30).Each drug was diluted to 100mL and infused by an electric pump at a rate of 1mL/h with a patient-controlled bolus of 1 mL after a loading dose of fentanyl 0.04mg and droperidol 1.5mg.The visual analog scale(VAS)of patient controlled analgesia(PCA),drug consumption and incidence of side effects were recorded within 48 hours postoperatively.Results The VAS of two groups were similar at rest. The VAS values of group F at 4 and 8h after operation were significantly higher than those of group S on exertion (all P＜0.05),which became similar when at rest.The consumption of analgesic drugs was comparable between the two groups;but the time required for supplemental bolus in group F was significantly higher than that of group S(all P＜0.05)during postoperative 2-8 hours period.The respiration rate(RR)and oxygen saturation(SpO_2) dropped significantly within 4h in both groups,and the drop of group F was more obviously than group S 2h after operation(all P＜0.05).The degrees of sedation in group S at various time points were significantly deeper than those of group F(all P＜0.05)in the first 20 hours after operation.The incidences of nausea and vomiting were similar in both groups.Conclusion Intravenous postoperative analgesia with equivalent dose of sufentanil has a better analgesic effect than fentanyl.The sedation effect is stronger and the respiratory depression is less in patients receiving sufentanil compared with those receiving fentanyl.