不同浓度罗哌卡因配伍咪达唑仑、舒芬太尼对胸外科老年患者术后硬膜外镇痛效果的临床比较  

Clinical efficacy comparison of ropivacaine under different concentrations combined with midazolam and sufentanil on elderly patients with epidural analgesia after chest surgery

作　　者：赵江峰[1] 刘华[1] 于鹏[1] 郑晓春[2] 

机构地区：[1]江苏省东台市人民医院麻醉科,江苏东台224200 [2]福建省立医院麻醉科,福建福州350001

出　　处：《中国生化药物杂志》2014年第5期8-10,共3页Chinese Journal of Biochemical Pharmaceutics

基　　金：福建省自然科学基金资助项目(2013J01116)

摘　　要：目的比较不同浓度罗哌卡因配伍咪达唑仑、舒芬太尼用于东台市人民医院胸外科老年患者术后硬膜外镇痛的临床效果。方法选择2010年9月~2013年9月胸外科老年手术患者100例,随机分为A、B、C和D4组,分别给予0.3μg/mL咪达唑仑、0.2μg/mL舒芬太尼和不同浓度罗哌卡因(0.100%、0.125%、0.150%、0.175%),进行硬膜外镇痛,记录4组患者术后4 h、8 h、12h、24 h和48 h的视觉模拟评分法(visual analogue scale,VAS)疼痛评分、Bromage运动神经阻滞评分分级以及不良反应等指标进行组间比较。结果 A组镇痛效果欠佳,术后4 h、8 h、12 h、24 h和48 h时VAS评分高于其他3组,差异有统计学意义(P<0.05),B、C、D3组间差异无统计学意义;D组有1例发生运动神经阻滞,术后4 h、8 h、12 h、24 h和48 h时Bromage评分高于其他3个组,差异有统计学意义(P<0.05);4组不良反应比较,差异无统计学意义。结论 0.125%~0.150%罗哌卡因与0.3μg/mL咪达唑仑及0.2μg/mL舒芬太尼联合使用能够提供安全可靠的胸外科术后镇痛效果。Objective To compare clinical efficacy of ropivacaine under different concentrations combined with midazolam and sufentanil on elderly patients with epidural analgesia after chest surgery. Methods From September 2010 to September 2013,100 cases elderly patients with chest surgery were selected,and divided into groups A,B,C and D,randomly. They were received different concentrations of ropivacaine(0. 10%,0. 125%,0. 15% and 0. 175%) combined with midazolam 0. 3 μg /mL and sufentanil 0. 2 μg /mL through epidural analgesia. Visual analogue scale(VAS) scores,Bromage scores and adverse reactions were respectively recorded and compared at 4 h, 8 h, 12 h, 24 h and 48 h in four groups after surgery. Results The VAS score of group A was significantly higher than that of groups B,C,D(P < 0. 05) at 4 h,8 h,12 h,24 h and 48 h. There were no significant differences among group B,C,D; There was 1 case with motor nervous block in group D. The Bromage score of group D was higher than that of groups A,B,C(P < 0. 05) at 4 h,8 h,12 h,24 h and 48 h; adverse reactions were compared in four groups,there were no statistical differences. Conclusion Ropivacaine of 0. 125% ~ 0. 150% combined with midazolam 0. 3 μg /mL and sufentanil 0. 2 μg /mL is effective and safe epidural analgesia after chest surgery.

关 键 词：罗哌卡因 咪达唑仑 舒芬太尼 镇痛 

分 类 号：R271.1[医药卫生—中医妇科学]