甲磺酸罗哌卡因与盐酸罗哌卡因复合舒芬太尼用于硬膜外术后镇痛的比较

COMPARISON OF THE EFFECT BETWEEN ROPIVACAINE MESYLATE AND ROPIVACAINE HYDROCHLORIDE COMBINED WITH SUFENTANIL IN POST-OPERATION EPIDURAL ANALGESIA

目的比较下腹部手术后甲磺酸罗哌卡因、盐酸罗哌卡因复合舒芬太尼应用于硬膜外术后自控镇痛(PCEA)的临床有效性和安全性。方法80例下腹部手术患者随机分为两组,(n=40):对照组术后应用0.15%盐酸罗哌卡因复合舒芬太尼(0.4μg/ml)作PCEA;试验组应用0.179%甲磺酸罗哌卡因复合舒芬太尼(0.4μg/ml)作PCEA。采用视觉模拟评分法(VAS)评价患者疼痛程度,采用改良的Bromage分级法评估下肢运动阻滞程度,记录镇痛质量、PCEA情况和不良反应发生情况。结果两组患者术后VAS评分、镇痛质量、运动阻滞程度及不良反应的发生率比较,差异无统计学意义(p>0.05)。结论0.179%甲磺酸罗哌卡因加舒芬太尼0.4μg/ml,可用于术后PCEA,其镇痛效果和安全性与0.15%盐酸罗哌卡因加舒芬太尼0.4μg/ml相似。

Objective To compare the clinical effectiveness and safeness between the post- operative use of ropivacaine mesylate composited sufentanil and ropivacaine hydrochloride combined sufentanil for PCEA （Postoperative Epidural Controlled Analgesia） on the patients undergoing lower abdominal surgery and intraoperative epidural anesthesia. Methods Eighty patients dealt with lower abdominal surgery were divided into two groups （n = 40） ：Control group （ropivacaine hydrochloride of 0. 15% combined with sufentanil（0. 4 μg/ml） adopted） and Test group （ropivacaine mesylate of 0. 179% composited sufentanil （0. 4μg/ml） adopted）. The degree of the pain was assessed by VAS （Visual Analogue Score）. The improved Bromage Method contribute to assess the degree of Iower limb motor block, as well as record the analgesic level, effectiveness of PCEA, and the occurrence of adverse reactions. Results According to VAS, there is no statistical significance to prove the differences between the two group （ test group and control group）, at the aspect of the analgesic level, effectiveness of PCEA, and the occurrence of adverse reactions. Conclusion There is no remarkable difference of the effectiveness and safeness between the ropivacaine mesylate of 0. 179% composite sufentanil 0. 4 μg/ml and ropivacaine hydrochloride of 0. 15% combined with sufentani 10. 4 μg/ ml when used for PCEA.