Effects of sufentanil on stress hormone and hemodynamic parameters in patients with sepsis in ICU / 中华急诊医学杂志

ABSTRACT

Objective To investigate the effects of sufentanil on stress hormone and hemodynamic parameters in patients with sepsis in ICU. Methods A prospective randomized controlled study was carried out to select 46 patients with sepsis admitted to the ICU of Guangzhou Red Cross Hospital from October 2014 to August 2016. The patients were randomly divided into the control group(group C), fentanyl group (group F) and sufentanil group (group S). Patients in group C were given active treatment of the primary disease, and anti-infection, nutritional support, maintenance of electrolyte balance and other comprehensive treatment. Patients in group F and group S were treated in the same way as group C, while fentanyl and sufentanil were applied separately into them. The analgesic goal was behavioral pain scale (BPS) ≤3 points. The changes of stress hormone [adrenocorticotropic hormone (ACTH), glucocorticoids (GC), norepinephrine (NE) and epinephrine (E)] and hemodynamic parameters [heart rate (HR), mean arterial pressure (MAP) and central venous pressure (CVP)] before and after treatment were compared, and adverse drug reactions were recorded. The quantitative data were compared by analysis of variance or t test, and the repeated measurement data were analyzed by repeated measures analysis of variance. The enumeration data were compared by Chi-square test or Fisher exact probability method. Results There were no significant changes in the levels of NE and E before treatment and at 2 and 6 h after the treatment in the three groups (P>0.05). Compared with before treatment, there were no significant changes in ACTH and GC levels at 2 and 6 h after treatment in group C (P>0.05), and ACTH and GC levels decreased in group F and group S at 2 and 6 h after treatment (P<0.05). Compared with group C, the levels of ACTH and GC in group F and group S were lower than those in group C at 2 and 6 h after treatment (P<0.05), but there was no significant difference between group F and group S (P>0.05). Compared with before treatment, the levels of HR were decreased at 2 and 6 h after the treatment in the three groups (P<0.05). Compared with group C, the levels of HR in group F and group S was lower than that in group C at 2 and 6 h after treatment (P<0.05), but there was no significant difference between group F and group S (P>0.05). Compared with before treatment, the levels of MAP increased in different degrees at 2 and 6 h after treatment in the three groups; Except for group F, there was significant difference between group C and group S (P<0.05). The levels of MAP in group F were lower than those in group C and group S at 2 and 6 h after treatment (P<0.05), but there was no significant difference between group S and group C (P>0.05). Conclusions Sufentanil has certain advantages in alleviating stress response in patients with sepsis in ICU. Its efficacy and safety are similar to that of fentanyl. What' more, it has more stable hemodynamics.