舒芬太尼硬膜外持续输注用于踝部术后镇痛的效应  

Effects of epidural Sufentanil infusions used for ankle fracture patients postoperative analgesia

作　　者：黄雪芬[1] 

机构地区：[1]浙江省台州市中医院麻醉科,浙江台州318000

出　　处：《中国现代医生》2012年第13期101-102,104,共3页China Modern Doctor

摘　　要：目的观察不同剂量舒芬太尼硬膜外持续输注用于踝部术后镇痛的效应。方法选择择期硬膜外阻滞下踝部手术患者120例(ASAⅠ～Ⅱ级),随机分为三组各40例。Ⅰ组舒芬太尼0.03μg/(kg.h)硬膜外持续输注术后镇痛(PCEA);Ⅱ组0.45μg/(kg.h);Ⅲ组0.06μg/(kg.h),各组均与0.178%甲磺酸罗哌卡因配伍。观察术后镇痛效果,记录VAS评分、镇痛泵使用情况、是否使用其他镇痛药物以及不良反应。结果Ⅱ组、Ⅲ组的患者给药后6、12、24及48 h各时间点镇痛评分(VAS评分)、自控按压次数及48 h内辅助镇痛用药量均低于Ⅰ组(P均<0.05);Ⅰ组、Ⅱ组的恶心和呕吐发生率与Ⅲ组比较无统计学意义(P>0.05)。Ⅰ组、Ⅱ组和Ⅲ组的呼吸抑制及瘙痒发生率呈逐渐增加的趋势,但两两间比较无统计学意义(P>0.05)。结论硬膜外持续输注舒芬太尼0.45μg/(kg.h)与0.178%甲磺酸罗哌卡因的混合液具有较佳的镇痛效果且副作用少。Objective To observe the effects of epidural Sufentanil infusion in different dosage used for postoperative analgesia in ankle fracture patients. Methods All of 120 patients fo ASA Ⅰ-Ⅱ ankle fracture surgery patients under epidural block anesthesia were randomly divided into three groups（n = 40, each group）： Group I received sufentanil 0.03 μg（kg＇h） for postoperative analgesia through ambulatory epidural analgesia（PCEA）; group Ⅱ received sufentanil 0.45 μg/（kg＂ h） and group m received sufentanil 0.06 μg（kg.h）, each group was compatibility of medicines with 0.178% Ropivacaine Mesylate injection. Visual analogue score,epidural analgesia pump＇s service condition, whether to use other analgesic drugs and side effects were recorded at the end of operation.Results Analgesic score（VAS score） at 6,12,24 and 48 hour after operation ,times of press the pump and use of assist analgesic drugs within 48 hours in group II or Ⅲ were below group I ＇s（P 〈 0.05 ）.The incidence of nausea and vomiting in Group Ⅰ or Ⅱ compared with group Ⅲ had statistically significant difference （P 〈 0.05）. Each group of respiratory inhibition and itching were gradually increasing incidence, but between two groups was no statistically significant （P 〉 0.05）. Conclusion Sufentanil 0.45 μg/（kg＇h） and 0.178% Ropivacaine Mesylate injection can be used for PCEA in ankle fracture patient＇s postoperative analgesia with better effects and less side effects.

关 键 词：舒芬太尼 硬膜外镇痛 踝部手术 

分 类 号：R614[医药卫生—麻醉学]