芬太尼复合罗哌卡因用于剖宫产术后硬膜外镇痛的临床观察

Clinical Effect of Fentanyl Combined with Ropivacaine for Cesarean Section Postoperative Epidural Analgesia

目的:比较吗啡与不同浓度芬太尼分别复合罗哌卡因用于剖宫产硬膜外镇痛的镇痛效果及相关不良反应。方法:选择行择期剖宫产的初产妇120例,ASA分级Ⅰ～Ⅱ级,随机分为对照组(M组),观察组(F1组,F2组,F3组),术后硬膜外镇痛分别使用吗啡0.1mg/ml,芬太尼(3μg/ml,4μg/ml,5μg/ml)复合0.178 8%罗哌卡因。镇痛泵固定持续输注速度2ml/h,于术后不同时点随访,评估静止、活动时切口的疼痛程度、下肢运动阻滞程度及相关不良反应。结果:F3及M组皆获得满意镇痛效果,但M组的不良反应发生情况明显高于其他组(P<0.05)。结论:5μg/ml芬太尼复合0.178 8%罗哌卡因镇痛效果确切,不良反应发生率低,值得临床推广。

Objective：To compare analgesic effect and side effects of morphine with different concentrations of fentanyl both composite ropivacaine for cesarean section epidural analgesia.Methods：120 ASA Ⅰ ~Ⅱ parturient women undergoing cesarean section received PCEA for 48 hours after operation,randomly divided into control group（M group）,the observation group（Group F1,F2,F3 group）.The PCEA solution contained of 0.178 8% ropivacaine plus morphine 0.1mg/ml,or fentanyl（3μg/ml,4μg/ml and 5μg/ml）.Fixed analgesia pump infusion rate of 2ml/h,at different time follow-up to assess the VAS score of rest pain,dynamic pain,modified Bromage score and side effects.Results：The F3 and the M group have satisfactory analgesic effect,but the side effects of M group was significantly higher than other groups（P0.05）.Conclusion：5μg/ml fentanyl plus 0.178 8% ropivacaine for epidural analgesia have exact effect with low incidences of side effects,which is worthy of clinical promotion.