硬膜外氢吗啡酮对舒芬太尼静脉镇痛剂量的影响  

Influence of Dosage of Sufentanil in Intravenous Postoperative Analgesia with Single-injection Epidural Hydrophone

作　　者：涂刚 郑荃菁 TU Gang;ZHENG Quanjing(The Second People's Hospital of Tree Gorges University,Yichang 443000,China)

机构地区：[1]三峡大学宜昌市第二人民医院,湖北宜昌443000

出　　处：《中国医药指南》2021年第10期47-48,51,共3页Guide of China Medicine

摘　　要：目的对硬膜外单次注射小剂量氢吗啡酮伍用不同剂量舒芬太尼用于剖宫产手术后静脉镇痛的效果进行比较,探讨合理的舒芬太尼静脉镇痛剂量,为临床提供一种合理的复合镇痛方法。方法120例ASAⅠ~Ⅱ级在CSEA下行剖宫产手术的孕妇,根据镇痛泵舒芬太尼用量的不同随机分成Ⅰ、Ⅱ、Ⅲ三个组,每组40例。Ⅰ组泵内舒芬太尼用量为1.0μg/kg;Ⅱ组舒芬太尼用量为1.5μg/kg;Ⅲ组舒芬太尼2.0μg/kg。3组孕妇术毕于硬膜外导管注射用盐水稀释至8 mL的氢吗啡酮0.2 mg。观察并比较术后不同时点镇痛评分(VAS)、镇静评分(Ramsay)、并发症发生率、有效按压加药次数。结果Ⅱ、Ⅲ两组产妇的VAS值分别与同时点Ⅰ组相比明显降低(P<0.05),但Ⅱ、Ⅲ两组同时点VAS值比较差异无显著性(P>0.05)。Ⅲ组40例产妇术后同时点的Ramsay镇静评分、并发症发生率明显高于Ⅰ、Ⅱ两组产妇,且产妇PCA按压次数少于Ⅰ、Ⅱ两组产妇(P<0.05)。Ⅰ、Ⅱ两组之间的Ramsay镇静评分、并发症发生率、PCA按压次数比较,差异无显著性(P>0.05)。结论硬膜外单次注射0.2 mg氢吗啡酮可以明显减少舒芬太尼静脉镇痛的剂量,降低并发症的发生率,推荐舒芬太尼静脉镇痛的最佳剂量为1.5μg/kg,不要超过2.0μg/kg。Objective Compared the effects that single injection of small dose of epidural hydrophone with different doses of intravenous sufentanil for analgesia after cesarean section.Finding an appropriate analgesic dose of sufentanil and provide a new and rational clinical analgesia methods.Methods One hundred and twenty ASAⅠ-Ⅱclass pregnant women will prepare caesarean section under CSEA,according to dosage of sufentanil analgesia were randomly divided intoⅠ,Ⅱ,Ⅲthree groups,40 cases in each group.GroupⅠ:sufentanil dosage of 1.0μg/kg;GroupⅡ:sufentanil dosage of 1.5μg/kg;GroupⅢ:sufentanil 2.0μg/kg.Hydrophone 0.2 mg with saline diluted to 8 mL were inject to the epidural after the operation end.The pain score(VAS),sedation score(Ramsay)complications rate,effective frequencies of pressing.Results The VAS values of the puerpera in the two groupsⅡandⅢwere significantly lower than those in the groupⅠat the same time(P<0.05),but there was no significant difference in the VAS values between the two groups at the same time in the groupⅡand groupsⅢ(P>0.05).The Ramsay sedation score and the complication rate of 40 parturients in groupⅢwere significantly higher than those in groupsⅠandⅡ,and the number of PCA compressions for parturients was less than that in groupsⅠandⅡ(P<0.05).The Ramsay sedation score,complication rate,and PCA compressions between the two groups were not significantly different(P>0.05).Conclusions Epidural hydrophone after a single 2 mg given with intravenous sufentanil analgesia,can significantly reduce the dosage of sufentanil,the best analgesic dose of sufentanil is 1.5-2.0μg/kg,and no more than 2.0μg/kg.

关 键 词：硬膜外 氢吗啡酮 静脉镇痛 舒芬太尼 剂量 

分 类 号：R614[医药卫生—麻醉学]