舒芬太尼复合罗哌卡因对TURP术后硬膜外自控镇痛的临床观察

Evaluati on Sufentanil Combined with Ropivaeaine in Patient-Controlled Epidural Analgesia After TURP Surgery

目的观察舒芬太尼复合罗哌卡因对TURP术后硬膜外自控镇痛的临床应用。方法80例择期TURP(Transurethral resection of the prostate)者,术后行PCEA(patient-controlled epidural analgesia),随机分为四组,Ⅰ、Ⅱ、Ⅲ、Ⅳ组配伍分别为:0.27%罗哌卡因+(0.25、0.5、0.75、1ug/ml)舒芬太尼。记录疼痛视觉模拟评分(visual analogue scale,VAS)、术后运动神经阻滞恢复评分(改良Bromage分级)不良反应,以及手术当日及三天内膀胱痉挛次数。结果与Ⅰ组比较,Ⅱ组,Ⅲ组,Ⅳ组在镇痛开始后4,8,16,20,24hVAS评分和膀胱痉挛次数明显低,Ⅱ组,Ⅲ组,Ⅳ组间无统计学意义,与Ⅰ组比较,副反应的发生率在余各组均高,但Ⅱ组又明显低于Ⅲ、Ⅳ组(P<0.05)。结论0.5ug/ml舒芬太尼复合0.2罗哌卡因镇痛效果好,副作用少,能有效减少膀胱痉挛次数。

Objective To assess the clinical efficacy of Sufentanil combined with ropivaeaine in patient-controlled epidural analgesia After undergoning TURP Surgery.Methods In this double-blind , eighty patienrs ,scheduled for TURP under epidural anesthesia, were randomly divided into 4 group （n=20）. each received 0.2% ropivaeaine combined with （0.25／0.50／.75／1）ug/ml Suf. The analgesic effects were assessed by using the visual analog scale （VAS）, modified Bromage score and the incidence of side effects were recorded. Items Including cystospasm times on the day and the three days after operation. Result compared with Ⅰ ,the VAS and the times of cystospasm was lower in group Ⅱ, Ⅲ,Ⅳ at 4,8,12,24h, no diffenrence among geoup Ⅱ, Ⅲ,Ⅳ,and the incidence of adverse events was higher（p） in group Ⅱ ,Ⅲ,Ⅳ, but group Ⅱ obvious lower than group Ⅲ,Ⅳ,Conclusion 0.5 ug/ml Suf in combined with 0.2% rop can provide better postoperative pain control and may release cystospasm, times, meanwhile decrease patint＇s post-operative complication.