地佐辛与舒芬太尼用于剖宫产术后硬膜外镇痛的临床效果比较  

Comparison of Clinic Effect between Dezocine and Sufentanil for Postoperative Analgesia after Cesarean Section

作　　者：刘康[1] 王龙[1] 曹经山[1] 

机构地区：[1]武汉大学人民医院麻醉科,湖北武汉430060

出　　处：《华南国防医学杂志》2013年第11期802-804,共3页Military Medical Journal of South China

摘　　要：目的比较地佐辛和舒芬太尼用于剖宫产术后持续硬膜外输注镇痛的临床效果和安全性。方法选择经硬膜外麻醉的剖宫产手术产妇60例,随机分为两组,A组:舒芬太尼50μg+0.178%甲磺酸罗哌卡因100 ml;B组:地佐辛10 mg+0.178%甲磺酸罗哌卡因100 ml。手术结束前15 min给予PCEA负荷量,PCEA持续背景剂量为2 ml/h,自控剂量为0.5 ml,锁定15 min。对2组切口痛及内脏痛视觉模拟评分(visual analogue scale,VAS)评分、Ramsay评分、Bromage评级、不良反应及并发症进行观察并记录。结果两组对切口痛的镇痛效果无统计学差异(P>0.05),但B组对内脏痛的镇痛作用强于A组(P<0.05);两组Bromage评级无统计学差异(P>0.05);两组Ramsay评分B组高于A组(P<0.05);总的不良反应发生率A组高于B组(P<0.05)。结论10 mg地佐辛复合0.178%甲磺酸罗哌卡因用于剖宫产术后硬膜外镇痛效果确切,不良反应和副作用发生率低。Objective To compare the clinical effect and safety of dezocine and sufentanil in postoperative patient- controlled epiduraI analgesia （PCEA） after cesarean section. Methods A total of 60 puerperae undergoing cesarean sec- tion through epidural anesthesia were randomly divided into group A treated with 50 μg sufentanil and 10 mg dezocine re spectively combined with 100 ml of 0. 178 % methansulfonic ropivacaine. PCEA load was given 15 minutes before the end of the surgery, the baseline dose of PCEA was 2ml/h, the patient-controlled dose was 0. 5 ml and the lock time was 15 minutes. The visual analogue scale （VAS） score of incision and visceral pain, Ramsay score, modified Bromage score, and the adverse reactions and complications of the patients were observed. Results The VAS score of incision pain and the Bromage score were not significantly different between two groups （P^0. 05）. The VAS score of visceral pain was high- er, the Ramsay score was lower and the incidence of adverse reactions was higher in group A than those in group B （P〈 0.05）. Conclusion The combination of 10 mg Dezocine and 0. 178% methansulfonic ropivacaine has clear effect in epi- dural anesthesia of patients after cesarean section, and the incidence of adverse reaction and side effect is low.

关 键 词：地佐辛 舒芬太尼 剖宫产 术后硬膜外镇痛 

分 类 号：R971.2[医药卫生—药品]