Clinical Study of Patient-controlled Intravenous Analgesia with Remifentanil or Fentanyl in Thoracic Postoperative Patients

Objective: To observe clinical efficacy of equivaent dose of remifentanil or fentanyl for patient controlled intravenous analgesia(PCIA) in thoracic postoperative patients.Methods: Forty ASA Ⅰ~Ⅱ patients(40～60 years) undergoing radical operation of lung or esophageal cancer were randomly divided into two group,the remifentanil intravenous analgesia groups(group R,remifentanil 10 ug/ml) and fentanyl intravenous analgesia group(group F,fentanyl 10 ug/ml).The PCIA device was set at backgrond infusion 2.0 ml/h,bolus 2.0ml and lockout time 15minutes.The pain intensity(VAS),cumulative analgesic consumption(CAC),sedative scores and side effects at 24,48h after administration were recorded.SpO2,RR,BP and ECG were continuously monitored.Results: There were no significant differences of CAC between two groups,however the VAS in group R was lower than that in group F(P0.05) and sedative efficacy of group R was superior than that of group F(P0.05).There were no significant differences of nausea and vomiting between two groups(P0.05).There were no significant differences of SpO2,RR,HR and MAP between two groups.Conclusion: PCIA with remifentanil can provide better efficacy of anagesia and sedation than with fentanyl,and lower incidence of nausea 、 vomiting and respiratory depression in thoracic postoperative patients.