舒芬太尼用于腹部手术后病人硬膜外自控镇痛的临床观察  

Clinical Study on Effect of Patient-controlled Epidural Analgesia with Sufentanil after Abdominal Surgery

作　　者：朱宝和[1] 高涛[2] 贺德[1] 黄冬凌[1] 

机构地区：[1]南方医科大学附属宝安人民医院普外科,广东深圳518101 [2]南方医科大学附属宝安人民医院麻醉科,广东深圳518101

出　　处：《湖北民族学院学报（医学版）》2008年第2期36-38,41,共4页Journal of Hubei Minzu University(Medical Edition)

基　　金：广东省自然科学基金项目(05001785)

摘　　要：目的探讨舒芬太尼硬膜外自控镇痛(PCEA)的临床效果及对腹部术后胃肠功能的影响。方法90例腹部手术病人随机分为三组,每组30例,分别接受舒芬太尼PCEA、芬太尼PCEA或疼痛时肌注哌替啶,观察三组术后镇痛效果、不良反应、肠蠕动恢复以及肛门排气、排便时间,同时检测血浆胃动素(MOT)水平。结果两个PCEA组各时段疼痛评分均低于对照组,镇痛满意度高;舒芬太尼组不良反应发生率显著低于芬太尼组,与对照组相似,但恶心、呕吐发生率显著低于对照组;舒芬太尼组肠蠕动恢复、肛门排气、排便时间较芬太尼和对照组显著缩短;术后血浆MOT水平舒芬太尼组迅速恢复,术后48 h恢复到术前水平,较芬太尼和对照组(72 h)快,术后24、48 h血浆MOT水平显著高于芬太尼和对照组。结论舒芬太尼PCEA安全、有效,通过增加血浆MOT水平,促进胃肠功能恢复。Objective To investigate the analgesic efficacy of patient-controlled epidural analgesia（PCEA） with sufentanil after abdominal surgery.Methods Ninety patients underwent abdominal surgery were randomized into three groups,30 patients in each group,and received sufentanil PCEA,fentanyl PCEA or pethidine injection.Postoperative analgesic effect,side effect,enterocinesia time,exsufflation time,micturition time and serum motilin level were analysed.Results Analgesic effect in PCEA group was superior to control group.The rate of side effect in sufentanil PCEA group was lower than in fentanyl PCEA group.The difference of side effect between sufentanil PCEA and control group had not statistic significance,but the rate of nausea and emesis in sufentanil PCEA group was lower than in control group.The enterocinesia time,exsufflation time and micturition time in sufentanil PCEA group were significantly shortened.The serum motilin level in sufentanil PCEA group recovered quickly,and the levels at 24h and 48 h after operation were significantly higher than those in fentanyl PCEA or control group.Conclusions PCEA with sufentanil is safe and effective after abdominal surgery,and promotes the recovery of gastrointestinal function by increasing the serum motiline level.

关 键 词：舒芬太尼 硬膜外自控镇痛 胃肠功能 

分 类 号：R614.42[医药卫生—麻醉学]