地佐辛、芬太尼、舒芬太尼复合盐酸罗哌卡因用于硬膜外麻醉临床效果观察

Clinical observation of dezocine,fentanyl and sufentanil combined with ropivacaine hydrochloride for fast onset time of epidural anesthesia and curative effect enhancement of analgesia

目的探讨地佐辛、芬太尼、舒芬太尼联合盐酸罗哌卡因用于增快硬膜外麻醉起效时间及增强阵痛的疗效。方法研究对象选取我院行硬膜外麻醉手术患者120例,随机分为Ⅰ组(联合地佐辛组)、Ⅱ组(联合芬太尼组)和Ⅲ组(联合舒芬太尼组)各40例。采用对应的联合麻醉用药行硬膜外麻醉,观察并记录患者在各项生理指标、硬膜外麻醉镇痛起效时间、硬膜外麻醉后5 min(T0)、10 min(T1)、15 min(T2)、20 min(T3)时点的疼痛(参照VAS标准)评分、舒适度(参照BCS标准)评分以及不良反应发生情况。结果Ⅰ组麻醉起效时间(7.81±0.31)min明显优于Ⅱ组(15.41±1.81)min和Ⅲ组(10.71±0.51)min(P<0.05)。在增强镇痛作用方面,在完成硬膜外麻醉后5 min(T0)、10 min(T1)、15 min(T2)、20 min(T3)时点的VAS评分Ⅰ组分数均低于Ⅱ组、Ⅲ组,Ⅰ组BCS评分均高于Ⅱ组、Ⅲ组,差异有统计学意义(P<0.05),且Ⅰ组的不良反应总发生率明显低于Ⅱ组、Ⅲ组(P<0.05)。结论地佐辛联合盐酸罗哌卡因用于硬膜外麻醉有起效快、镇痛效果明显等特点,安全性好,是临床麻醉有效的镇痛方案。

Objective To observe and compare the analgestic curative effect of Dezocine, Fentanyl and Sufentanil combined with Ropivacaine Hydrochloride to speed up the onset time of epidural anesthesia and increase. Methods 120 patients with CEA operations in our hospital were selected and randomly divided into group Ⅰ （combined with Dezocine）, group Ⅱ （combined with Fentanyl） and group Ⅲ （combined with Sufentanil）, 40 cases in each group. The onset time of CEA operation and the analgestic effect were assessed with the methods of VAS and BCS sores and the patients were observed to see whether they had adverse reactions. Results The onset time of Group Ⅰ （7.8±0.3）min was significantly better than Group Ⅱ （15.4±1.8）min and Group Ⅲ （10.7±0.5）min（P〈0.05）; After 5 min（T0）, 10 min （T1）, 15 min（T2）, 20 min（T3） of anesthesia, VAS scores of Group Ⅰwere lower than those of Group Ⅱ and Group Ⅲ; BCS scores of Group Ⅰ were higher than those of Group Ⅱ and Group Ⅲ （P〈0.05）; The total rate of adverse reac- tions of GroupⅠ was significantly lower than that of Group Ⅱ and Group Ⅲ（P〈0.05）. Conclusion For epidural anes- thesia, Dezocine combined with Ropivacaine Hydrochloride has a fast onset time, better effect of analgesia, long dura- tion, lower incidence rate of adverse reactions which is safety and feasibility.