22. Evaluation of pain relief effectiveness of sufentanil and midazolam complex after major maxillofacial surgery
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Abstract
Pain after major surgery in the maxillofacial region greatly affects the patient’s daily activities and recovery. We performed an RCT study on 60 patients undergoing major maxillofacial surgery who were divided into two groups: group 1 used TCI sufentanil in combination with midazolam and group 2 used TCI sufentanil alone for postoperative pain relief. Results: evaluating the effectiveness of sedation according to OAA/S at T0 (starting TCI): the two groups were similar; from T1 (1h) to T7 (24h) group 2 was lower than group 1 (p < 0.05). From T0 to T7, to achieve similar VAS pain relief, group 1 had the number of pain rescues (1.86 ± 0.72 times) and total drug intake (67.91 ± 9.87mcg) is lower than group 2 (with p < 0.01) with the corresponding data of 5.63 ± 1.45 times and 75.75 ± 14.06mcg. Conclusion: Using TCI sufentanil in combination with midazolam after major maxillofacial surgery had better sedation, analgesia and reduced drug consumption than TCI sufentanil alone.
Article Details
Keywords
TCI, sufentanil, midazolam, maxillofacial surgery
References
2. Sinatra R. Causes and consequences of inadequate management of acute pain. Pain Med Malden Mass. 2010;11(12):1859-1871. doi: 10.1111/j.1526-4637.2010.00983.x.
3. Walter JM, Corbridge TC, Singer BD. Invasive mechanical ventilation. South Med J. 2018;111(12):746-753. doi: 10.14423/SMJ.0000000000000905.
4. Guarracino F, Lapolla F, Cariello C, et al. Target controlled infusion: TCI. Minerva Anestesiol. 2005;71(6):335-337.
5. Gepts E, Shafer SL, Camu F, et al. Linearity of pharmacokinetics and model estimation of sufentanil. Anesthesiology. 1995;83(6):1194-1204. doi: 10.1097/00000542-199512000-00010.
6. Luger TJ, Hill† HF, Schlager A. Can midazolam diminish sufentanil analgesia in patients with major trauma? A retrospective study with 43 patients. Drug Metabol Drug Interact. 1992;10(1-2). doi: 10.1515/DMDI.1992.10.1-2.177.
7. Korak-Leiter M, Likar R, Oher M, et al. Withdrawal following sufentanil/propofol and sufentanil/midazolam. Sedation in surgical ICU patients: correlation with central nervous parameters and endogenous opioids. Intensive Care Med. 2005;31(3):380-387. doi: 10.1007/s00134-005-2579-3.
8. Lamblin V, Favory R, Boulo M, Mathieu D. Microcirculatory alterations induced by sedation in intensive care patients. Effects of midazolam alone and in association with sufentanil. Crit Care Lond Engl. 2006;10(6):R176. doi: 10.1186/cc5128.
9. Schraag S, Kreuer S, Bruhn J, Frenkel C, Albrecht S. Target-controlled infusion (TCI) - a concept with a future?: state-of-the-art, treatment recommendations and a look into the future. Anaesthesist. 2008;57(3):223-230. doi: 10.1007/s00101-008-1329-7.
10. Median effective effect-site concentration of sufentanil for wake-up test in adolescents undergoing surgery: a randomized trial - PMC. Accessed May 18, 2022. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4359582/.
11. Bastin R, Barvais L, Mélot C, Vincent JL, Berré J. Preliminary results of prolonged target controlled infusion of sufentanil adjusted to an effort pain score after cardiac surgery. Acta Anaesthesiol Belg. 2005;56(1):31-36.
12. Gao Y, Deng X, Yuan H, et al. Patient-controlled intravenous analgesia with combination of dexmedetomidine and sufentanil on patients after abdominal operation: A prospective, randomized, controlled, blinded, multicenter clinical study. Clin J Pain. 2018;34(2):155-161. doi: 10.1097/AJP.0000000000000527.
13. Lin C shui, Lu G, Ruan L yang, Gu M ning. Patient-controlled intravenous analgesia with sufentanil and fentanyl after thoracotomy: a comparative study. Nan Fang Yi Ke Da Xue Xue Bao. 2006;26(2):240-241,244.