吗啡与舒芬太尼用于子宫切除术术后硬膜外自控镇痛的比较

Comparison of Morphine and Sufentanil in Postoperative Patient-controlled Epidural Analgesia for Patients undergone Hysterectomy

目的比较吗啡与舒芬太尼用于硬膜外术后自控镇痛的临床疗效和不良反应。方法将80例行子宫切除术的患者随机分两组:吗啡组和舒芬太尼组。每组40例。两组患者麻醉方法均采用硬膜外联合腰麻,术后经硬膜外导管分别给予吗啡或舒芬太尼自控镇痛。记录两组患者术后4、8、12、24、48h的镇痛效果(VAS评分)、镇静程度(Ramsay评分)及可能出现的不良反应,如恶心、呕吐、瘙痒等。结果吗啡组与舒芬太尼组患者镇痛效果和镇静程度的差异无统计学意义(P>0.05)。吗啡组不良反应发生率高于舒芬太尼组(P<0.05)。结论小剂量的舒芬太尼用于硬膜外术后自控镇痛可取得满意的镇痛效果和较小的不良反应。

Objective To compare the clinical effects and side-effects of morphine and sufentanil in postoperative patient-controlled epidural analgesia （PCEA）. Methods Eighty patients （ASA Ⅰ - Ⅱ ） undergone hysterectomy were randomly divided into two groups： morphine group （group M, n=40） and sufentanil group （group SF, n=40）. Group M were given morphine for postoperative PCEA and group SF with sufentanil. Visual analogue scales（VAS）, Ramsay scales and side-effects including pruritus, nausea and emesis were assessed after 4, 8, 12, 24 and 48h of postoperative analgesia. Results The VAS scores and Ramsay scales scores were of no significant difference between two groups （P〉0.05）. The incidence of side-effects including pruritus, nausea and emesis was significantly higher in group M than that in group SF （P〈0.05）. Conclusion Small dose of sufentanil in postoperative PCEA can obtain a satisfactory analgesia effect and fewer side-effects.