舒芬太尼复合罗哌卡因用于妇科肿瘤手术后硬膜外自控镇痛的临床观察

The cilnical effect of Sufentanil combined with Ropivacaine on patient controlled extradural analgesia

目的:观察舒芬太尼复合罗哌卡因用于妇科肿瘤术后硬膜外自控镇痛的临床效果。方法:随机选择妇科肿瘤手术患者90例,ASAⅠ-Ⅱ级,年龄32-53岁,体重42-61kg。随机分为三组,每组30例。A组:镇痛泵配方为0.2%罗哌卡因+舒芬太尼0.5μg/ml+氟哌利多5mg+生理盐水稀释至100ml。B组:镇痛泵配方为0.2%罗哌卡因+舒芬太尼0.75μg/ml+氟哌利多5mg+生理盐水稀释至100ml;C组:镇痛泵配方为0.2%罗哌卡因+舒芬太尼1.0μg/ml+氟哌利多5mg+生理盐水稀释至100ml。三组镇痛泵均设置为维持量2ml/h,自控给药剂量0.5ml/次,锁定时间15min。对术后即刻、6h、12h、24h进行镇痛镇静评分并观察不良反应。结果:三组患者镇痛镇静评分比较,B组和C组低于A组,有统计学差异(P<0.05),B组和C组之间无统计学差异(P>0.05)。不良反应比较,A组和B组少于C组,有统计学差异(P<0.05),A组和B组之间无统计学差异(P>0.05)。结论:舒芬太尼用于妇科肿瘤术后硬膜外自控镇痛安全有效,而以舒芬太尼0.75μg/ml剂量的配方镇痛效果好,不良反应小。

Objective：To observe the clinical effect of Sufentanil combined with ropivacaine on patient controlled extradural analgesia（PCEA）. Methods ： Ninty patients, ASA Ⅰ - Ⅱ, undergoing gynecological tumor operation were randomly divided into three groups. Group A：the composition of PCEA 0.2% Ropivacaine , sufentanil 0.5 μg/ml and 5mg Haloperidol added to 100ml with normal saline. Group B ：sufentanil 0.75 txg/ml , and others were same as group A. Group C ：sufentmail 1.0μg/ml ,others same as group A. All the subjects were carried on VAS and RSS score on postoperative instantly and 6h, 12h,24h after operation with PCEA （ maintenance dose 2ml/h, PCA0.5 ml, interval time 15 min）. Results ：VAS and RSS score were lower in group B and C than group A, there was significant difference （P 〈 O. 05 ） ;and no significant difference between group B and C （P 〉 0.05 ）. The incidence of adverse reaction in group A and B was lower than that of in group C, there was significant difference between them （P 〈 0.05 ）, and no significant difference between group A and B （ P 〉 0.05 ）. Conclusion： Sufentanil can be used for PCEA securely, and the dosage of sufentanill O. 75 μg/ml is better.