舒芬太尼复合罗哌卡因用于腹式子宫切除手术硬膜外麻醉效果的临床观察  

Efficacy of sufentanil addition to ropivacaine epidural anesthesia for hysterectomy

作　　者：彭为平[1] 刘朝晖[1] 王仁儒[1] 莫平[1] 罗勇[1] 邵泳尧[1] 刘茂东[1] 

机构地区：[1]广东省佛山市南海区人民医院麻醉科,528200

出　　处：《中国现代药物应用》2009年第11期26-27,共2页Chinese Journal of Modern Drug Application

摘　　要：目的观察舒芬太尼复合罗哌卡因应用于腹式子宫切除手术硬膜外麻醉的效果。方法60例ASAI～Ⅱ级行腹式子宫切除手术的患者随机分为三组:Ⅰ组(生理盐水1ml+1%罗哌卡因10ml)、Ⅱ组(舒芬太尼10μg/ml+1%罗哌卡因10ml)、Ⅲ组(舒芬太尼20μg/ml+1%罗哌卡因10ml),每组均为20例。选择L1-2间隙硬膜外麻醉,试验量2%利多卡因3ml,各组分别追加研究剂量。记录麻醉的起效时间、感觉阻滞达最高平面时间、镇痛持续时间、改良Bromage评分和麻醉效果。结果Ⅱ、Ⅲ组起效时间及阻滞达最高平面时间较I组缩短,镇痛持续时间延长(P<0.05),改良Bromage评分和麻醉效果差异无统计学意义(P>0.05)。Ⅱ、Ⅲ组分别有2例和5例出现瘙痒,Ⅲ组有1例患者恶心呕吐,其余患者未观察到恶心呕吐、呼吸抑制等不良反应。结论小剂量舒芬太尼(10μg)复合罗哌卡因可以增强硬膜外麻醉效果且不良反应少。Objective To observe the anesthesic effect of sufentanil addition to epidural ropivacaine for hysterectomy. Methods 60 patients （ASA Ⅰ-Ⅱ） scheduled for hysterectomy were divided randomly into 3 groups with 20 patients each. Epidural anesthesia was performed at L2-3 interspace. The catheter was advanced 4 cm into the epidural space in cephalic direction. Correct epidural catheter placement was confirmed with 2% lidocaine 3 ml. Epidural anesthesia was produced with 1% ropivacaine 10 ml （group Ⅰ）, or 1% ropivacaine 10 ml plus 10 （group Ⅱ） or 20 （group Ⅲ）microg of sufentanil （n = 20 each）. The onset time and the time of block to the highest level,duration of analgesia, Bromage scale and anesthetic efficacy were recorded and compared. Results Compared with group Ⅰ, the onset time and the time of block to the highest level of analgesia shortend significantly in group Ⅱ and Ⅲ（P 〈0. 05）. The duration of analgesia in group Ⅱ and Ⅲ were longer than that in group Ⅰ（P 〈0. 05）. The Bromage scale and anesthetic efficacy did not differ between the groups. （P 〉 0. 05 ）. Conclusion Our results suggest that addition of 10 microg of sufentanil improve the epidural anesthesia with 1% ropivacaine for hvsterectomy.

关 键 词：舒芬太尼 罗哌卡因 硬膜外麻醉 

分 类 号：R614[医药卫生—麻醉学]