摘要
目的探讨舒芬太尼复合罗哌卡因用于子宫切除术后硬膜外自控镇痛(PCEA)的效果并与等效剂量的芬太尼比较。方法择期经腹行子宫切除术患者120例,ASAⅠ～Ⅱ级,采用随机双盲法分为2组:RF组和RS组,每组60例。术后硬膜外自控镇痛分别采用芬太尼6μg/mL、舒芬太尼0.6μg/mL复合0.2%罗哌卡因。观察和记录患者术后镇痛开始前,开始后2、4、8、16、24h视觉模拟法(VAS)评分、Bromage改良运动评分、总按压次数/实际有效进药次数(D1/D2)比值及术后恶心、呕吐等不良反应发生情况。结果镇痛开始后两组VAS评分较镇痛开始前均显著下降(P<0.01);与RF组比较,RS组镇痛开始后2h时的VAS评分显著降低(P<0.01),镇痛开始后24h内实际有效按压次数显著减少(P<0.01);两组患者镇痛开始后Bromage改良运动评分差异无统计学意义(P>0.05),且未发生恶心、呕吐等不良反应。结论 0.6μg/mL舒芬太尼复合0.2%罗哌卡因用于经腹子宫切除术后PCEA能获得更满意的镇痛效果,且不良反应发生率低。
Objective To compare and investigate the efficiency of sufentanil or fentanyl in combination with ropivacaJne in patient-controlled epidural analgesia（PCEA） for post-abdominal total hysterectomy analgesia. Methods ASA Ⅰ-Ⅱ patients （n=120） with elective abdominal total hysterectomy were randomly assigned to two groups： Group RF with 60 in it and Group RS with 60 in it , and Group RF received fentanyl 6μg/ml in combination with 0.2% ropivaeaine for PCEA postoperatively and Group RS received sufentanil 0.6μg/ml in combination with 0.2% ropivacaine for PCEA postoperatively. The VAS score, modified Bromage scales, the ratio between the total number of attempts （D1） and the number of successfully delivered doses （D2）（D1/ D2） were recorded before PCEA started and 2, 4, 8, 16 and 24 h after PCEA started. Side effects such as nausea and vomiting were also recorded. Results The VAS of two groups was significantly decreased after PCEA started compared with that before PCEA（P〈0.01）, and the VAS of Group RS was significantly lower than that of Group RF at 2h after PCEA started （P〈0.01）. The D2 was significantly decreased in 24h after PCEA started （P〈0.01）. The modified Bromage scales and the incidence of side effects had no significant difference between the two groups （P〉0.05）. Conclusion In PCEA 0.2% ropivacaine plus sufentanil 0.6μg/ml provides better analgesia after abdominal total hysterectomy, with fewer side effects.
出处
《中国现代医生》
2010年第29期36-37,39,共3页
China Modern Doctor
关键词
舒芬太尼
芬太尼
罗哌卡因
镇痛
硬膜外
子宫切除
Sufentanil
Fentanyl
Ropivacaine
Analgesia
Epidural
Abdominal total hysterectomy
