剖宫产术后不同药物自控镇痛效果临床观察

Effect of patient controlled analgesia with different drugs in patients after cesarean section

目的观察低浓度舒芬太尼、芬太尼和曲马多3种药物对剖宫产患者术后自控镇痛(PCA)的效果及不良反应。方法 60例腰硬联合麻醉下行剖宫产手术且自愿接受PCA的产妇随机分为舒芬太尼组、芬太尼组和曲马多组,每组20例。观察3组产妇术后各时点疼痛视觉模拟(VAS)评分、镇痛满意度、镇静Ramsay评级及不良反应等。结果 3组患者VAS评分、镇痛药耗量、镇静Ramsay评分、镇痛满意度评分比较差异均无统计学意义(P>0.05);3组患者恶心、呕吐、皮肤瘙痒、尿潴留等并发症的发生率比较差异也无统计学意义(P>0.05)。结论低浓度舒芬太尼、芬太尼和曲马多用于剖宫产术后PCA,均能起到良好的镇痛效果,安全性高,不良反应发生率低。

Objective To observed the effect and adverse reaction of patient controlled analgesia（PCA） with low con- centration of sufentanil, fentanyl and tramadol in patients after cesarean section. Methods Sixty patients who voluntarily ac- cepted PCA after uterine-incision delivery under spinal and epidural anesthesia were randomly divided into sufentanil group, fentanyl group and tramadol group, twenty cases in eack group. The visual analogue scales （VAS）score, postoperative analgesic satisfaction score, Ramsay score and the adverse effect at several time points after operation were observed. Results There was no significant difference in VAS score, analgesic consumption, Ramsay score and analgesic satisfaction score among three groups （ P 〉 0.05 ）. There was no significant difference in the incidence of nauseated, emesia, itch of skin and uroschesis among three groups （ P 〉 0.05 ）. Conclusion Low concentrations of sufentanil, fentanyl and tramadol for PCA in patients after cesare- an section can obtain good analgesic effect with high safety to puerpera and neonatus, and few adverse reactions.