舒芬太尼和吗啡持续硬膜外输注术后镇痛效应的比较

Comparison of the efficacy of epidural infusion with sufentanil and morphine for postoperative analgesia

目的比较舒芬太尼和吗啡持续硬膜外输注术后镇痛的效应。方法择期妇科手术患者60例，行硬膜外麻醉后，随机分为两组：吗啡镇痛组（Ⅰ组），给予吗啡2mg、罗哌卡因75mg加生理盐水至100ml；舒芬太尼镇痛组（Ⅱ组），给予舒芬太尼100μg、罗哌卡因75mg加生理盐水至100ml行硬膜外术后镇痛。观察术后4、8、24、48h时间点患者的视觉模拟评分（VAS评分）、Ram—say镇静评分、Bromage运动神经阻滞评分．以及恶心、呕吐、瘙痒和呼吸抑制等不良反应。结果Ⅱ组术后4、8、24、48h时间点患者的VAS评分均低于1组（P〈0．05）。1组术后的恶心、呕吐、皮肤瘙痒发生率均高于Ⅱ组（P〈0．05）。结论和吗啡相比，舒芬太尼复合罗哌卡因用于硬膜外术后镇痛．能够产生较理想的镇痛效果。和减少术后镇痛副作用的发生。

Objective To compare the efficacy of epidural infusion with sufentanil and morphine for postoperative analgesia in patients underwent gynecological operation. Methods Sixty patients, scheduled for selective gynecological operation, were given epidural anesthesia and randomly divided into 2 groups （72 -30） at the end of operation. In morphine analgesia group （group Ⅰ） morphine 2mg and in sufentanil analgesia group （group Ⅱ） sufentanil 100μg was received. In each group ropivacaine 75mg was added and diluted to 100ml with normal saline as postoperative analgesi a. Visual analogue scales （VAS）, Ramsay sedation scales, Bromage motor score and side effects such as nausea, vomiting and pruritus were observed at 4, 8, 24 and 48 hour after operation. Result The VAS were lower in group Ⅱ than that in group 1 at 4, 8, 24 and 48 hour after operation （P〈 0.05）. The incidences of nausea,vomiting and pruritus were higher in group I than that in group II （P〈0.05）. Conclusion Epidural infusion of sufentanil 100μg combined with ropivaeaine 75mg as postoperative analgesia could provide satisfied analgesic effects and few side effects for patients underwent gynecological operation.