盐酸氯普鲁卡因复合舒芬太尼用于剖宫产术后镇痛的临床观察

Clinical observation on chloroprocaine hydrochloride combined sufentanil for postoperative analgesia with cesarean section

目的 探讨盐酸氯普鲁卡因复合舒芬太尼用于剖宫产术后硬膜外镇痛的效果和安全性.方法 选取择期美国麻醉医师协会（ASA）I～Ⅱ级剖宫产手术患者80例,随机分为观察组和对照组,每组40例.观察组患者术后硬膜外镇痛给予1.0％盐酸氯普鲁卡因＋0.5μg/mL舒芬太尼;对照组患者给予0.125％罗哌卡因＋0.5 μg/mL舒芬太尼.观察并记录手术结束时,术后4、8、16、24、48h视觉模拟评分（VAS评分）和下肢运动神经阻滞改良Bromage评分,术后排气时间及不良反应发生情况.结果 两组患者均获得了满意的镇痛效果,改良Bromage评分、术后排气时间及不良反应发生情况比较差异无统计学意义（P＞0.05）.结论 1.0％盐酸氯普鲁卡因复合0.5 μg/mL舒芬太尼用于剖宫产术后硬膜外镇痛安全有效,值得临床推广应用.

Objective To investigate the effects and safety of chloroprocaine hydrochloride （CH） combined with sufentanil for patient controlled epidural analgesia （PCEA） during cesarean section. Methods A total of 80 cases of ASA Ⅰ - Ⅱ receiving cesarean section were randomly divided into the observation group and the control group, 40 cases in each group. Patiens in the observation group with PCEA were given mixture of 1.0% CH and 0.5pLg/mL sufentanil. Patiens in the control group were given mixture of 0.125% ropivacaine and 0.5μg/mLsufentanil. Observe and record the visual analogue scale （VAS） and modified Bromage score of lower extremity motor nerve block at the end of operation, 4, 8.16, 24, 48 hours after operation and the occurrence of adverse reactions, postoperative exhaust time. Results Two groups of patients obtained satisfactory analgesia. There were no significant difference about modified Bromage score, postopera- tive exhaust time and the occurrence of adverse reactions （P≥0.05）. Conclusion The 1% CH combined with 0.5μg/mL sufentanil for postoperative analgesia with cesarean section is safe and effective, h is worthy of clinical application.