舒芬太尼复合罗哌卡因用于术后硬膜外病人自控镇痛  

POSTOPERATTVE PCEA WITH SUFENTANIL PLUS ROPIVACAINE

作　　者：姚彤[1] 吴新民[1] 应舜伟[1] 

机构地区：[1]北京大学第一医院麻醉科,北京100034

出　　处：《中国疼痛医学杂志》2005年第3期157-160,共4页Chinese Journal of Pain Medicine

摘　　要：目的观察舒芬太尼或芬太尼复合罗哌卡因用于腹部手术后PCEA的临床镇痛效果和不良反应。方法选择ASAⅠⅡ级,在连续硬膜外阻滞或复合全身麻醉下行腹部手术的病人100例,术后行硬膜外病人自控镇痛(PCEA)。随机分为两组,使用0.5μg/ml舒芬太尼或2μg/ml芬太尼复合0.12%罗哌卡因。背景剂量4ml/h,自控药量2ml/次,锁定时间20min。观察病人术后镇痛效果,记录镇痛泵使用情况、不良反应以及是否使用其它镇痛药物。结果舒芬太尼组在术后24小时和48小时的静息、咳嗽和活动时镇痛效果优于芬太尼组(P<0.05)。恶心呕吐发生率低,程度轻(P<0.05)。两组镇痛泵使用情况以及其他不良反应如下肢麻木、呼吸抑制等无明显差异。结论舒芬太尼可安全有效地用于腹部手术后PCEA,镇痛效果优于芬太尼,不良反应少,程度较轻。Objective: To observe the analgesic and side effects of sufentanil or fentanyl combined with ropivacaine in postoperative patients with controlled epidural analgesia (PCEA). Methods:100 patients,ASA I～II,under going abdominal operation, were randomly divided into two groups. Sufentanil 0.5μg/ml or fentanyl 2 μg/ml with 0.12% ropivacaine were given epidurally after surgery, respectively, with basal dose of 4 ml/h, PCA dose of 2ml and lockout time of 20 min. Postoperative analgesic effects, PCEA pump usage,drug comsumption and side effects were observed within 48 hr. Results: Analgesic effects in group sufentanil were superior to group fentanyl when patients were in the state of rest, coughing or moving respectively (P<0.05). Less severe nausea and vomiting were recorded in group sufentanil. Analgesic drug consumption was comparable in two groups. Conclusion: Sufentanil with ropivacaine could be safe in PCEA after abdominal surgery. Sufentanil had better analgesic effect than fentanyl, with less side effects.

关 键 词：术后硬膜外病人自控镇痛 舒芬太尼 罗哌卡因 术后PCEA 连续硬膜外阻滞 不良反应 复合全身麻醉 术后镇痛效果 腹部手术 背景剂量 镇痛药物 恶心呕吐 下肢麻木 呼吸抑制 镇痛泵 ASA 5μg 发生率 ml 

分 类 号：R614[医药卫生—麻醉学]