舒芬太尼复合罗哌卡因用于胸科术后硬膜外镇痛的效果观察

The Observation on Postoperative Patient-controlled Epidural Analgesia After General Thoracic Surgey

目的观察舒芬太尼复合罗哌卡因用于胸科手术后硬膜外自控镇痛（PCEA）的效果及不良反应。方法选择美国麻醉医师协会（ASA）Ⅰ～Ⅱ级在连续；哽膜外复合全身麻醉下行胸科手术的患者60例，术后行PCEA60例患者随机分为两组，使用0．5mg／L舒芬太尼（S组）或0．1g／L吗啡（M组）复合0．12％罗哌卡因，观察两组患者术后镇痛效果及不良反应。结果两组患者术后96h内VAS评分比较，差异均无统计学意义（P〉0．05）。两组患者术后24h镇静评分比较差异有统计学意义（P〈O．05）。两组患者S组术后恶心．呕吐、皮肤瘙痒发生率低于M组，差异有统计学意义（P〈0．05）。结论开胸手术后0．5mg／L舒芬太尼复合0．12％罗哌卡因PCEA镇痛效果好，不良反应少。

Objective To observe the analgesic and side effects of sufentanil combined with ropivacaine in postoperative patients with controlled epidural analgesia（PCEA） Methods Sixty ASA Ⅰ- Ⅱ patients undergoing elective general thoracic surgey, were randomly divided into two groups, Sufentanil 0. 5ug/mL（ group S ） or morphine 0.1mg,/mL（ group M） with ropivacaine were given epidurally after surgey. Postoperative analgesic effects and side effects were observed. Results There is no singnificent different between two groups in VAS during postoperative 96 hours （ P 〉 0.05 ）, and the sedative score is different in two groups during postoperative 24 hours （P 〈 0.05 ）. Less severe nausea, vomiting and purisus were recored in group sufentanil than in group morphine. Conclusion Sufentanil combined with ropivacaine had better analgesic effect and less side effect in postoperative patients.