舒芬太尼联合罗哌卡因用于瘢痕子宫与非瘢痕子宫剖宫产术后镇痛效果比较

目的评价不同浓度的舒芬太尼联合罗哌卡因用于瘢痕子宫与非瘢痕子宫剖宫产术后镇痛的效果。方法2018年6月至2019年3月拟在腰硬联合麻醉下行剖宫产术的产妇80例,术后均采用硬膜外镇痛。随机分为四组:非瘢痕子宫低浓度组(L1组)和高浓度组(H1组),瘢痕子宫低浓度组(L2组)和高浓度组(H2组)。比较四组产妇的镇痛效果。结果瘢痕子宫低浓度组(L2组)患者术后静息痛与活动痛均高于其他三组(L1组、H1组、H2组)(P<0.05);与非瘢痕子宫高浓度组(Hl组)比较,瘢痕子宫高浓度组(H2组)患者24 h、48 h活动痛显著升高(P<0.05);并且瘢痕子宫组产妇24 h镇痛泵实际进药次数和按压次数/实际进药次数比值均显著高于非瘢痕子宫组产妇(P<0.05);两组间恶心呕吐、瘙痒、尿潴留等不良反应无显著差异(P>0.05)()结论1 p-g/ml舒芬太尼复合0.125%罗哌卡因用于瘢痕子宫剖宫产术后患者硬膜外自控镇痛效果好,不良反应低,适合临床应用。

Objective To evaluate the analgesic effects of different concentrations of sufentanil combined with ropivacaine on the post-cesarean analgesia of scarred and non-scarred utems patients.Methods From June 2018 to March 2019,80 patients who were planed to perform cesarean resection under CSEA were enrolled in this study.Epidural analgesia was used after operation.They were randomly divided into four groups:non-scar uterus low-concentration group(LI group)and high-concentration group(H1 group),scar uterus low-concentration group(L2 group)and high-concentration group(H2 group).The analgesic effect of four groups of puerpera was compared.Results The results showed that the rest pain and activity pain of patients in the scar uterus low-concentration group(L2 group)were higher than those in the other three groups(LI group、Hl group、H2 group)(P<0.05).Compared with the non-scar uterus high-concentration group(Hl group),the activity pain of patients in the scar uterus high-concentration group(H2 group)was significantly increased at 24 h and 48 h(P<0.05).Moreover,the actual administration times and the ratio of press times to actual administration times were significantly higher in the scarred uterus patients than in the non-scarred uterus patients(P<0.05).PONV,pruritus,urinary retention and other adverse events had no significant statistical difference(P>0.05).Conclusion The PCEA formula of lug/ml sufentanil combined with 0.125%ropivacaine for post-cesarean analgesia of the scarred uterus patients has good analgesic effects and low side effects.