舒芬太尼复合罗哌卡因用于术后硬膜外病人自控镇痛

Epidural Analgesia with Sufentanil Combined with Ropivacaine that was controlled by Patient with Upper Abdominal Surgery

目的观察舒芬太尼复合罗哌卡因用于上腹部手术后硬膜外病人白控镇痛（PCEA）的效应。方法选择40例ASAⅠ～Ⅱ级在硬膜外复合全麻下行上腹部手术病人，随机均分为S、F两组。术后采用硬膜外镇痛模式为负荷量（5mL）＋持续剂量（2mL／h）＋PCA剂量（0．5mL），锁定时间15min。S组镇痛药为0．25％罗哌卡因＋舒芬太尼（0．5μg／mL）；F组镇痛药为0．25％罗哌卡因＋芬太尼（5μg／mL）。观察并记录术后3、6、12、24h视觉模拟评分（VAS）、Ramsay镇静评分和BCS舒适评分及恶心、呕吐、眩晕等不良反应发生情况。结果两组各相同时段VAS／BCS评分基本相似（P〉0．05）。两组不良反应发生率无明显差异，两组病人生命体征稳定。结论舒芬太尼复合罗哌卡因PCEA用于上腹部手术后安全有效。

Objective To investigate the effect of epidural analgesia（PCEA） with sufentanil combined ropivacaine that was controlled by patients with upper abdominal surgery. Methods Forty patients（ASA Ⅰ-Ⅱ ） undergoing upper abdominal surgery under epidural anesthesia combined with general anesthesia were randomly divided into two groups. Group S received sufentanil 0.5 μg/mL＋0.25%ropivacaine for PCEA; Group F received PCEA with fentanily 0.5 μg/mL＋ 0.25% ropivaeaine. PCEA include loading dose 5 mL, bolus of 0.5 mL with lock time 15 minrtes and background 2 mL/h. The analgesia effects were evaluated by visual scales and Bruggrmann comfort scale. Side effects such as nausea and vomiting were also recorded. Results Both group S and group F showed good pain relif. There were not any significant differences of VAS scores and BCS between two groups. There were also not any differences of side effects. Conclusion PCEA with sufentanil＋0. 25% ropivacaine was safe and effective for patient after upper abdominal surgery.