摘要
目的 观察不同剂量舒芬太尼联合罗哌卡因用于下肢手术后患者硬膜外自控镇痛（PCEA）的临床效果和不良反应.方法 选择60例ASAⅠ～Ⅱ级行下肢手术的患者,随机分为三组（a、b、c）各20例,术后行PCEA分别使用0.12%罗哌卡因（a组）,0.12%罗哌卡因＋0.5 μg/ml舒芬太尼（b组）,0.12%罗哌卡因＋0.75 μg/ml舒芬太尼（c组）.观察并记录三组生命体征以及术后4、6、12、24 h时的视觉模拟（VSA）评分、PCEA总用药量、镇痛泵按压次数及恶心、呕吐、皮肤瘙痒、呼吸抑制等副作用.结果 b组和c组患者术后VAS评分显著低于a组（P〈0.05）,b、c组无明显差异;镇痛泵按压次数a组明显大于b组和c组（P〈0.01）,b、c组无明显差异;a组、b组、c组的瘙痒发生率分别为0%、54.5%、63.6%,各组间瘙痒的发生率差异有统计学意义（P〈0.05）;60例患者均未发生呼吸抑制等严重并发症.结论 0.12%罗哌卡因联合0.5 μg/ml舒芬太尼可取得较佳的镇痛效果及较少的副作用.
Objective To observe the clinic effect and side effects of different concentration of sufentanil combined with ropivacaine in patients controlled epidural analgesia（PCEA） after lower limbs surgery. Methods Sixty patients （ASA Ⅰ - Ⅱ ） scheduled for the lower limbs surgery were divided randomly into three groups （ a,b,c groups） with 20 patients each. Group a received with 0.12% ropivacaine,Group b received with 0.12% ropivacaine ＋ sufentanil 0.5 μg/ml,Group c received with 0.12% ropivacaine ＋ sufentanil 0. 75 μg/ml. The degree of pain was evaluated by visual analogue scales（VAS） , the requirements of PCA and side effects such as nausea,vomiting ,respiratory depression and itch of skin were also recorded at 4,6,12 and 24 hour after operation. Results VAS pain scores in group b and c were significantly lower than in group a （ P 〈 0.05 ） , which was no significant difference between group b and c. PCA pressure times of group a was significantly higher than group b and c （ P 〈 0.01 ） , which was no significant difference between group b and c. Pruritus incidence in the three groups was 0 % , 54.5 % and 63.6 % in proper order , and there was significant difference between the three groups（ P 〈 0.05 ）. All the patients had no severe complications such as respiratory depression. Conclusion Sufentanil 0.5 μg/ml with ropivacaine 0. 12 % could be safe in PEA after lower limbs surgery,which had the best analgesic effect, with less side effects.
出处
《临床外科杂志》
2009年第10期691-692,共2页
Journal of Clinical Surgery
关键词
舒芬太尼
罗哌卡因
术后镇痛
sufentanil
ropivaeaine
postoperative analgesia
