舒芬太尼用于下肢骨科手术后硬膜外镇痛的临床观察  

Sufentanil for Patient-controlled Epidural Analgesia in Patients Undergoing Lower Limb Ormopaedic urgery

作　　者：王庆安[1] 杜祯华 WANG Qing-an, DU Zhen-hua （Department of Anesthesiology, Sichuan Province Santai County People＇s Hospital, Santai 621100, China）

机构地区：[1]四川省三台县人民医院麻醉科,四川三台621100

出　　处：《医学信息》2011年第23期185-186,共2页Journal of Medical Information

摘　　要：目的观察舒芬太尼复合罗哌卡因用于下肢骨科手术后硬膜外自控镇痛（PCEA）的临床镇痛效果和不良反应。方法选择ASAⅠ～Ⅱ级，连续硬膜外麻醉行下肢骨科手术病人60例，随机分为两组（n=30），使用0．5μg／ml舒芬太尼（S组）或3μg／ml 芬太尼（F组）复合0.15％罗哌卡因，术后行PCEA。结果S组术后6h、24h和48hv AS评分明显低于F组（P〈0.05）：S组各时间点镇静评分均明显大于F组（P〈0.05）；S组PCA按压次数显著低于F组（P〈0.05）；S组恶心、呕吐发生率低。其他不艮反应如呼吸抑制、下肢麻木等无明显差异。结论舒芬太尼复合罗哌卡因用于下肢骨科术后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 combined with ropivacaine for postoperative patient-controlled epidural analgesh （PCEA） in patients undergoing lower limb orthopaedic surgery. Methods 60 ASA Ⅰ -Ⅱ patients, undergoing lower limb orthopaedic surgery were randomly devided into two groups. Sufentanil 0.5μg/ml or fentanyl 3μg/ml with 0.15% ropivacainc were given epidurally after surgery. Results The VAS of postoperative 6h, 24h and 48h in group sufentanyl had significant differences with group fentanyl（P〈0.05）. The sedative scores of each time in group sufentanil were much bigger than those of group fentanyl（P〈 0.05）. The trigger time of PCA in group sufentanil was much smaller than that of group fentanyl. Less severe nausea and vomiting were recorded in group sufentanil. The other side effects were comparable in two groups. Conclusion Sufentanil combined with ropivacaine has a satisfactory effect on postoperative patient-controlled epidural analgesia in patients undergoing lower limb orthopaedic surgery. Sufentanil had better analgesic effect than fentanyl, with less side effects.

关 键 词：术后硬膜外镇痛 骨科手术病人 舒芬太尼 下肢麻木 临床观察 术后硬膜外自控镇痛 术后PCEA 连续硬膜外麻醉 

分 类 号：R614.42[医药卫生—麻醉学;医药卫生—临床医学;医药卫生—外科学]