舒芬太尼硬膜外镇痛对胃手术患者术后尿潴留的影响  

The effect of PCEA with sufentanil in ropivacaine on urinary retention in patients after gastric operation

作　　者：陈爱文[1] 黄波[1] 伍捡林[1] 刘安林[1] 

机构地区：[1]广州医学院附属深圳沙井医院麻醉科,518104

出　　处：《中国现代医药杂志》2008年第2期23-25,共3页Modern Medicine Journal of China

摘　　要：目的观察舒芬太尼和吗啡复合罗哌卡因术后硬膜外镇痛对胃手术患者尿潴留的影响。方法选择60例ASA1～2级择期胃部手术成年患者,随机分为舒芬太尼组(S组,n=30)和吗啡组(M组,n=30)进行PCEA。记录术后2天患者的VAS评分,恶心呕吐、瘙痒、低血压、尿潴留等副作用。结果S组术后排尿困难的发生率明显低于M组,P<0.01。术后第1天S组恶心呕吐、瘙痒和低血压的发生率也低于M组,P<0.05。结论舒芬太尼复合罗哌卡因用于胃手术术后硬膜外镇痛时,尿潴留的发生率很低,恶心呕吐、瘙痒和低血压的发生率也低于吗啡,提示术后持续导尿并非必须。Objective To compare side-effects of epidural sufentanil in ropivacaine with that of morphine in ropivacaine focusing on lower urinary tract function after gastric operation.Methods 60 patients undergoing gastric operation were randomly allocated to receive either sufentanil in ropivacaine （Group S, n=30） or morphine in ropivacaine （Group M, n=30） for their PCEA. Epidural catheter was inserted between the 9 and 10 thoracic spine. Visual analogue pain score and side-effects such as nausea, vomiting, pruritus, hypotension and urinary retention were evaluated during postoperative days （PODs） 1 and 2, Results The incidence of serious to major micturition problem in Group S was lower than that in Group M （P〈0.01）. The incidence of pruritus, nausea and vomiting was also lower in Group S than that in Group M on POD 1 （P〈0.05）. Conclusion The lower incidence of major/serious micturition problem in patients receiving sufentanil in ropivacaine thoracic epidural analgesia suggests that continuation of urinary drainage may not be necessary from POD 1.

关 键 词：舒芬太尼 吗啡 尿潴留 罗哌卡因 

分 类 号：R614[医药卫生—麻醉学]