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OBJECTIVE	To evaluate the sedation and analgesia power and security of sufentanil in intensive care unit ( ICU ) , and to compare the effect with fentanyl .
METHODS	A multicenter randomized controlled trial was conducted .
METHODS	Critical adult patients in ICU from 11 hospitals in Henan Province from June 2011 to January 2012 who needed analgesia based sedation were enrolled .
METHODS	These patients were randomly divided into two groups with 300 cases in each group using the envelope method according to the hospital number and time sequence number of inclusion .
METHODS	Exclusion criteria included the time of analgesia duration < 48 hours and who were under continuous renal replacement therapy ( CRRT ) treatment during analgesia .
METHODS	544 cases were enrolled finally , and there were 282 cases in sufentanil group and 262 in fentanyl group .
METHODS	Before using the drug , there was no statistically significant difference in age , body weight , acute physiology and chronic health evaluation II ( APACHEII ) score , Glasgow coma scale ( GCS ) between sufentanil group and fentanyl group , and were comparable .
METHODS	The goal of analgesia was faces pain scale ( FPS ) 2 .
METHODS	If the dosage of sufentanil and fentanyl exceeded the upper limited dose ( sufentanil 0.3 gkg ( -1 ) h ( -1 ) , fentanyl 2 gkg ( -1 ) h ( -1 ) ) but FPS could not meet ( still > 2 ) , and maintained the upper limited doses of sufentanil and fentanyl and added midazolam , and FPS2 or Ramsay 3 could meet the standard .
METHODS	The analgesia duration of all cases was 48-168 hours .
METHODS	Related data were collected for statistical analysis .
RESULTS	( 1 ) Compared with the data before the analgesia , the mean arterial pressure ( MAP ) of sufentanil analgesia after analgesia at different time points were significantly decreased ( F = 6.061 , P < 0.001 ) and closed to the normal level , FPS at different time point score were decreased significantly after analgesia ( F = 259.389 , P < 0.001 ) , and the changes in pulse oxygen saturation ( SpO ( 2 ) ) , respiratory rate and pulse were not found .
RESULTS	( 2 ) Compared with before the analgesia , the white blood cell count ( WBC ) , neutrophil percentage ( N ) , platelet count ( PLT ) , aspartate transaminase ( AST ) , creatinine ( Cr ) , arterial partial pressure of carbon dioxide ( PaCO ( 2 ) ) , blood lactic acid , blood sugar , C-reactive protein ( CRP ) were markedly reduced after sufentanil analgesia ( WBC : 10.8 4.2 10 ( 9 ) / L vs. 14.2 11.510 ( 9 ) / L , F = 49.879 , P < 0.001 ; N : 0.806 0.104 vs. 0.815 0.128 , F = 5.768 , P = 0.017 ; PLT : 160.4 77.0 10 ( 9 ) / L vs. 166.1 89.010 ( 9 ) / L , F = 6.568 , P = 0.011 ; AST : 61.3 10.1 U/L vs. 90.9 26.9 U/L , F = 6.706 , P = 0.010 ; Cr : 86.7 71.8 mol/L vs. 119.6 56.0 mol/L , F = 30.303 , P < 0.001 ; PaCO ( 2 ) : 39.4 7.2 mmHg vs. 41.7 22.6 mmHg , F = 4.389 , P = 0.037 ; blood lactic acid : 1.9 1.2 mmol/L vs. 2.7 2.5 mmol/L , F = 4.883 , P = 0.028 ; blood sugar : 8.0 5.4 mmol/L vs. 9.7 7.6 mmol/L , F = 9.724 , P = 0.002 ; CRP : 64.8 20.7 mg/L vs. 114.0 55.9 mg/L , F = 4.883 , P = 0.028 ) .
RESULTS	But there were no statistically significant differences in red blood cell count ( RBC ) , prothrombin time ( PT ) , activated partial thromboplastin time ( APTT ) , fibrinogen ( FIB ) , thrombin time ( TT ) , alanine aminotransferase ( ALT ) , total bilirubin ( TBil ) , albumin ( ALB ) , total protein ( TP ) blood urea nitrogen ( BUN ) , and arterial partial pressure of oxygen ( PaO ( 2 ) ) before and after sufentanil analgesia ( all P > 0.05 ) .
RESULTS	( 3 ) There was no statistically significant difference in effectiveness of sufentanil and five times dose of fentanyl ( P > 0.05 ) .
RESULTS	There was no statistically significant difference in the proportion of sedative drugs midazolam usage [ 18.4 % ( 52/282 ) vs. 24.8 % ( 65/262 ) , ( 2 ) = 1.151 , P = 0.283 ] and the rate of analgesia success [ 44.3 % ( 125/282 ) vs. 48.9 % ( 128/262 ) , ( 2 ) = 0.571 , P = 0.450 ] and analgesia success [ 16.3 % ( 46/282 ) vs. 15.3 % ( 40/262 ) , ( 2 ) = 0.066 , P = 0.798 ] between sufentanil and fentanyl group .
RESULTS	( 4 ) Comparison of adverse reactions : the incidence of hypotension in sufentanil group was significantly lower than that in fentanyl group [ 3.2 % ( 9/282 ) vs. 6.9 % ( 18/262 ) , ( 2 ) = 3.900 , P = 0.048 ] , and other common adverse reactions , such as respiratory depression/pause , nausea/vomiting and dizziness , pruritus , allergy , slow heart beat ( bradycardia ) and metabolic reactions had no statistically significant difference .
RESULTS	Addiction or tetanus of skeletal muscles was not found in both groups .
CONCLUSIONS	Compared with fentanyl , the analgesia efficacy of sufentanil is stronger .
CONCLUSIONS	Sufentanil has less physiological interference and lower incidence of adverse reactions for ICU patients .

