不同剂量舒芬太尼用于剖宫产术后硬膜外自控镇痛的效果比较

Effect of Postoperative Patient-Controlled Epidural Analgesia with Different Doses of Sufentanil after Cesarean Section

目的观察不同剂量的舒芬太尼用于剖宫产术后硬膜外自控镇痛的效果比较。方法将2009年4-11月60例硬膜外麻醉下行剖宫产手术术后的患者随机分为三组,术后镇痛液A组采用0.125%罗哌卡因复合0.3μg/mL舒芬太尼;B组为0.125%罗哌卡因复合0.4μg/mL舒芬太尼;C组0.125%罗哌卡因复合0.5μg/mL舒芬太尼,观察三组患者的术后镇痛效果(视觉模拟法评分,即VAS评分)及不良反应。结果 A组VAS评分高于B组和C组,B组VAS评分高于C组(P<0.05)。三组患者术后恶心呕吐、运动阻滞、嗜睡及肠蠕动抑制等并发症无统计学差异(P>0.05)。结论 0.125%罗哌卡因复合0.5μg/mL舒芬太尼以4mL/h持续输注用于剖宫产术后患者自控硬膜外镇痛术后疼痛VAS评分最小,患者镇痛满意度最高。

Objective To observe the effect of postoperative patient-controlled epidural analgesia （ PCEA） with three different doses of sufentanil combined with 0. 125% ropivacaine after cesarean section. Methods Data was collected from April 2009 to November 2009. Sixty patients after cesarean section under continuous epidural anesthesia were randomly divided into three different groups. Group A was given sufentanil 0. 3 μg/mL and 0. 125% ropivacaine for PCEA,group B was given sufentanil 0. 4 μg/mL and 0. 125% ropivacaine,group C was given sufentanil 0. 5 μg/mL and 0. 125% ropivacaine. The analgesia effects were evaluated by the visual analogue scales （ VAS）. Side effects were also recorded. Results The VAS scores were significantly the highest in group A than that in group B and group C,the VAS scores in group B were higher than that in group C （ P 〈0. 05）. The incidence of side effects,such as postoperative nausea and vomiting,lethargy,and pruritus,was not significant among the three groups （ P 〉0. 05）. Conclusion 0. 5 μg/ mL sufentanil and 0. 125% ropivacaine recommended for PCEA with background 4 mL/h is safe and effective for patients after cesarean section.