妇科手术口服塞来昔布联合硬膜外镇痛舒芬太尼最适剂量的测定  

The measurement of optimum dosage of sufentanil as an analgesia in epidural with celecoxib being used in hysterectomy

作　　者：唐红丽[1] 耿武军[1] 杨涛[1] 王权光[1] 陈丽梅[1] 徐旭仲[1] 

机构地区：[1]温州医学院附属第一医院麻醉科,325000

出　　处：《实用医学杂志》2012年第8期1336-1338,共3页The Journal of Practical Medicine

基　　金：温州市科技局基金项目(编号:Y20090131)

摘　　要：目的:探讨妇科手术口服塞来昔布联合硬膜外镇痛时舒芬太尼的最小有效剂量及安全性,以得出此时硬膜外舒芬太尼的最适剂量。方法:选择ASAⅠ～Ⅱ级因妇科开腹子宫切除术患者100例,分为4个亚组,每个亚组剂量选择采用修正的序贯法(modifiedstep-up-step-down approach),各组术前30min口服塞来昔布400mg,手术后8h口服塞来昔布200mg,硬膜外麻醉穿刺间隙选择L1-2椎间隙,术中常规监测ECG、NIBP、HR、SPO2,术毕接硬膜外镇痛泵送回病房,观察相关指标。结果:比较各组患者术后各时段疼痛强度(PI),得出口服塞来昔布时,硬膜外舒芬太尼最低有效剂量为30μg,组间结果差异有统计学意义(P<0.05),胃肠副反应、睡眠质量和镇痛满意度与剂量呈相关性。结论:通过对各亚组不同剂量舒芬太尼镇痛效果和不良反应发生率的观察,可得出在口服塞来昔布联合硬膜外镇痛时,舒芬太尼获得满意镇痛效果最低有效剂量为30μg组,持续镇痛满意。Objectives To explore the minimum dosage and safety of sufentanil as an epidural analgesia with eelecoxib being used in hysterectomy and to find out the optimum dosage of sufentanil. Methods According to modified step-up-step-down approach 100 patients in grade ASA I-11 who received epidural analgesia after hysterectomy were randomly divided into four sub-groups. Each patient receives oral celeeoxib 400 mg preoperative 30 min and celecoxib 200 mg after operation 8 hours. Epidural anesthesia needle selects between the L1-2 intervertebral space. All the patients in groups were routine monitoring ECG, NIBP, HR and SPO2 during the operations and sent to sickrooms with a patient-controlled epidural analgesia pump after operations and recorded relevant messages. Results According to different groups of PI on different time spots, the minimum dosage and safety of sufentanil as an epidural analgesia is 30 μg （P 〈 0.05）. Conclusions The minimum dosage and safety of sufentanii as an epidural analgesia with eelecoxib being used in hysterectomy is 30 μg, which possess continual strong analgesia.

关 键 词：子宫切除术 舒芬太尼 塞来昔布 最适剂量 

分 类 号：R614[医药卫生—麻醉学]