舒芬太尼复合罗哌卡因在产科硬膜外自控镇痛中的应用  

Application of sufentanil combined with ropivacaine for obstetric epidural analgesia in the cesarean section patients

作　　者：陈石卿[1] 

机构地区：[1]湘南学院附属医院麻醉科,湖南郴州423000

出　　处：《中国临床新医学》2010年第5期450-452,共3页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的探讨舒芬太尼复合罗哌卡因在产科硬膜外自控镇痛(PCEA)中的应用。方法选择90例腰硬联合麻醉下行剖宫产的产妇,随机分为三组(n=30)。分别应用0.2μg/ml舒芬太尼+0.125%罗哌卡因(A组),0.4μg/ml舒芬太尼+0.125%罗哌卡因(B组),0.6μg/ml舒芬太尼+0.125%罗哌卡因(C组)。术后行PCEA,即负荷剂量(5ml)+持续剂量(3ml/h)+PCA剂量(1ml/次)。比较分析术后0～、3～、6～、12～24h各时段切口痛、宫缩痛的VAS评分;24h内不良反应发生率(恶心、呕吐、瘙痒、运动阻滞、嗜睡、呼吸抑制)。结果术后PCEA,24h内随舒芬术尼浓度增大,切口痛VAS评分和宫缩痛VAS评分降低,其中B组、C组与A组评分比较差异有统计学意义(P<0.05),B组与C组VAS评分比较差异无统计学意义(P>0.05)。24h内不良反应中恶心、瘙痒的发生率随舒芬太尼浓度的增大而增多,其中C组与B组、A组比较差异有统计学意义(P<0.05),B组与A组两者比较差异无统计学意义(P>0.05)。三组的呕吐、运动阻滞、嗜睡情况比较,差异无统计学意义(P>0.05),未发生呼吸抑制。结论剖宫产术后PCEA,0.4μg/ml舒芬太尼复合0.125%罗哌卡因可取得较好的镇痛效果和较少的副作用。Objective To explore the application of sufentanil combined with ropivacaine for obstetric epidural analgesia in the cesarean section patient controlled epidural analgesia （PCEA）. Methods Ninety cases of cesarean section were randomly divided into three groups with spinal-epidural anesthesia, i.e. group A, group B and group C. There were 30 cases in each group. The patients received 0. 2 ug/ml sufentanil combined with 0. 125% ropivacaine in group A, 0.4 ug/ml sufentanil combined with 0. 125% ropivacaine in group B and 0. 6 ug/ml sufentanil combined with 0. 125% ropivacaine in group C, respectively. Postoperative PCEA were performed through loading dose （5 ml） ＋ continuous dose （3 ml/h） ＋ PCA dose （1 ml/times）. The data were analyzed on the VAS scoring of incision pain,uterine pain in the period of 0 - 3,3 - 6,6 -12,12 -24 h postoperatively and the incidence of adverse reactions such as nausea, vomiting, itching, motor block, lethargy, respiratory depression in the period of 0 - 24 h postoperatively. Results The incision pain VAS score and contraction VAS pain score decreased with sufentanil concentration increasing. The defference between Group B, group C and Group A had statistic significance（ P 〈 0. 05）. The defference between Group B and group C had not statistic signifieance（P 〉0.05）. The rate of adverse reactions in the nausea and the incidence of itching increased with sufentanil concentration increasesing. The defference between Group C and group B, Group A had statistic significance（P 〈0. 05 ）. The defference between Group B and group A had not statistic significance（ P 〉 0.05 ）. The incidence rate of vomiting, motor block, lethargy had not statistic significance（P 〉 0. 05 ） among the three group. No respiratory depression happened. Conclusion In the cesarean section PCEA, 0. 4ug/ml sufentanil combined with 0. 125% ropivacaine can get better analgesic effect and less side effects.

关 键 词：硬膜外镇痛 舒芬太尼 剖宫产 

分 类 号：R614.4[医药卫生—麻醉学]