舒芬太尼硬膜外镇痛用于治疗带状疱疹神经痛的增效作用效果观察  

Effect of sufentanil epidural sufentanil analgesia for treatment of herpes zoster of neuropathic pain

作　　者：李京霞[1] 刘东[1] 汤芹芹[1] 杨胜杰[2] 

机构地区：[1]成都市第二人民医院疼痛科,四川成都610017 [2]成都军区西坝第一干休所,云南昆明650032

出　　处：《实用医院临床杂志》2012年第5期172-174,共3页Practical Journal of Clinical Medicine

摘　　要：目的观察舒芬太尼硬膜外镇痛治疗带状疱疹神经痛的效果。方法 60例躯干部带状疱疹神经痛患者按随机数字表法分为常规硬膜外镇痛组(A组)和舒芬太尼镇痛组(B组)各30例。两组均给予2%利多卡因3 ml+复方倍他米松1ml+甲钴铵1 mg+0.9%NS 10 ml,在此基础上,B组加用舒芬太尼0.5μg/ml。观察两组治疗前后疼痛的改善情况及不良反应,并随访带状疱疹后遗神经痛的发生率。结果两组患者治疗后各时点与治疗前相比疼痛评分随时间延长而下降(P<0.05);舒芬太尼镇痛组治疗后各时点的视觉模拟评分(Visual analogue scale,VAS)与单纯硬膜外镇痛组比较差异均有统计学意义(P<0.05);两组未出现严重的不良反应,不良反应发生率两组间比较差异均无统计学意义(P>0.05)。治愈后随访3个月,A组1例出现后遗神经痛,B组无后遗神经痛发生。结论舒芬太尼用于硬膜外镇痛可提高带状疱疹神经痛的治疗效果,是一种安全有效的临床治疗方法。Objective To observe the effect of sufentanil epidural analgesia in herpes zoster of neuropathie pain. Methods Sixty patients suffering from HZ were randomly divide into conventional epidural analgesia group （group A） and sufentanil analgesia group （group B）. 30 cases of conventional epidural analgesia group were given 2% lidocaine 3 ml ＋ Meeobalamin 1 mg ＋0.9% NSIO ml ＋ Betamethasonel ml; sufentanil analgesia group were given 2% lidocaine 3 ml ＋ Betamethasonel ml ＋ Mecobalamin 1 mg ＋ sufen- tanil 0.5ug/ml ＋0.9% NS10 ml line. The clinical effect was evaluated before and after treatment by visual analogue scale（VAS）. The adverse effect and incidence of post-herpetic neuralgia were recorded. Compared to before treatment both groups showed a lower level of VAS at each time point of treatment （P 〈 O. 05）. Results The differences of the level of VAS between group A and group B were sta- tistically significant （ P 〈 0.05 ）. The adverse effects between the two groups were not significant. The follow-up visit showed that in group A, one patient have suffered from post-herpetic neuralgia and two patients in group B have suffered from post-herpetic neuralgia in three month after healing. Conclusion sufentanil for epidural analgesia can improve the treatment of herpes zoster of neuropathic pain, lower incidence of post-herpetic neuralgia,is a safe and effective clinical treatment.

关 键 词：舒芬太尼 硬膜外神经阻滞 带状疱疹神经痛 

分 类 号：R752.12[医药卫生—皮肤病学与性病学] R441.1[医药卫生—临床医学]