小量舒芬太尼复合吗啡用于剖宫产术后硬膜外镇痛  

Clinical Study of Epidural Postoperative Analgesia with Sufentanil Morphine Combination after Cesarean Section

作　　者：张佩军[1] 张庆[1] 王建波[1] 鲍瑞军[1] 

机构地区：[1]天津市中心妇产科医院麻醉科,天津300100

出　　处：《中国中西医结合外科杂志》2015年第1期38-41,共4页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:观察小量舒芬太尼复合吗啡在剖宫产术后硬膜外镇痛的效果及不良反应。方法:选择评分ⅠⅡ级、在腰-硬联合麻醉下行择期剖宫产术的60例患者随机分为三组,Ⅰ组(吗啡组)吗啡2 mg、0.5%罗哌卡因20 mg,Ⅱ组(舒芬太尼组)舒芬太尼20μg、0.5%罗哌卡因20 mg,Ⅲ组(舒芬太尼复合吗啡组)舒芬太尼10μg、吗啡2 mg、0.5%罗哌卡因20 mg。结果:Ⅱ组、Ⅲ组术后4h VAS评分与Ⅰ组比较明显较低(P<0.05);Ⅰ组和Ⅲ组术后8 h、24 h VAS评分较Ⅱ组低(P<0.05),Ⅰ组和Ⅲ组的术后有效镇痛时间均长于Ⅱ组(P<0.05);Ⅰ组瘙痒发生率较Ⅱ组、Ⅲ组略高(P<0.05)。结论:硬膜外注射舒芬太尼复合小剂量吗啡,不但镇痛作用时间长,并且早期镇痛完善,副作用少。Objective combination of sufentanil and morphine.MethodsSixty ASAⅠ~Ⅱpatients undergoing abdominal hysterecto-my surgery were randomly allocated into three groups. In group Ⅰ patients received morphine 2 mg plus 0.5%ropivacaine 20 mg through epidural catheter; In groupⅡ patients received sufentanil 20 μg plus 0.5% ropi-vacaine 20 mg and in group Ⅲ patients were given sufentanil 10 μg and morphine 2 mg plus 0.5% ropivacaine.ResultsVAS scores were significantly decreased at postoperative time 4 h in groups Ⅱ, Ⅲ and time 8 h,12 h in groupsⅠ and Ⅲ（P 0.05）, and patients in groupsⅠ and Ⅲ obtained longer duration of effective analge-sia（P 0.05）. There were no differences in the incidence of nausea and vomiting in the three groups but compar-ing with patients in group I, patients in groups Ⅱ had lower incidence of pruritus（P 0.05）.Conclusion Receiving epidural sufentanil 10 μ g and morphine 2 mg can provide early postoperative analgesia. Sufent-anil-morphine combination gets early postoperative analgesia perfectly and provides satisfying epidural analgesiain patients of abdominal total hysterectomy with lower incidence of adverse effects.

关 键 词：舒芬太尼 术后镇痛 吗啡 硬膜外注射 

分 类 号：R971.1[医药卫生—药品]