国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2012年
5期
662-665
,共4页
舒芬太尼%罗哌卡因%腰麻%超前镇痛%硬膜外镇痛
舒芬太尼%囉哌卡因%腰痳%超前鎮痛%硬膜外鎮痛
서분태니%라고잡인%요마%초전진통%경막외진통
Sufentanil%Ropivacaine%Spinal anesthesia%Preemptive analgesia%Epidural analgesia
目的 观察舒芬太尼复合罗哌卡因腰麻超前镇痛对术后硬膜外镇痛效果的影响.方法 将行妇科手术患者80例随机分为C组和S组,每组40侧.两组的麻醉镇痛方法分别为:C组0.5％罗哌卡因3 ml腰麻,硬膜外首次剂量为舒芬太尼7.5μg稀释成3ml;S组0.5％罗哌卡因3 ml+舒芬太尼2.5 μg/ml腰麻,硬膜外首次剂量为生理盐水3 ml.镇痛泵的配制均为:0.125％罗哌卡因+舒芬太尼0.5 μg/ml,背景剂量2ml/h,单次给药剂量为2ml,锁定时间为30min.观察并记录镇痛效果、镇痛药的使用量以及不良反应.结果 C组与S组相比VAS评分高和BCS评级低,S组在术后4、8、12、24 h的疼痛客观评分较C组低,C组PCEA期间的硬外总进药量[( 120.47±10.58) ml vs.(104.15±7.83) ml]比S组大,C组患者D1/D2比值大于5的比例(17.5％vs.5.0％)高于S组,S组不良反应少于C组.结论 舒芬太尼复合罗哌卡因腰麻超前镇痛能减轻术后疼痛,提高患者的舒适度,减少术后硬膜外镇痛药的需求量,且不良反应发生率低.
目的 觀察舒芬太尼複閤囉哌卡因腰痳超前鎮痛對術後硬膜外鎮痛效果的影響.方法 將行婦科手術患者80例隨機分為C組和S組,每組40側.兩組的痳醉鎮痛方法分彆為:C組0.5％囉哌卡因3 ml腰痳,硬膜外首次劑量為舒芬太尼7.5μg稀釋成3ml;S組0.5％囉哌卡因3 ml+舒芬太尼2.5 μg/ml腰痳,硬膜外首次劑量為生理鹽水3 ml.鎮痛泵的配製均為:0.125％囉哌卡因+舒芬太尼0.5 μg/ml,揹景劑量2ml/h,單次給藥劑量為2ml,鎖定時間為30min.觀察併記錄鎮痛效果、鎮痛藥的使用量以及不良反應.結果 C組與S組相比VAS評分高和BCS評級低,S組在術後4、8、12、24 h的疼痛客觀評分較C組低,C組PCEA期間的硬外總進藥量[( 120.47±10.58) ml vs.(104.15±7.83) ml]比S組大,C組患者D1/D2比值大于5的比例(17.5％vs.5.0％)高于S組,S組不良反應少于C組.結論 舒芬太尼複閤囉哌卡因腰痳超前鎮痛能減輕術後疼痛,提高患者的舒適度,減少術後硬膜外鎮痛藥的需求量,且不良反應髮生率低.
목적 관찰서분태니복합라고잡인요마초전진통대술후경막외진통효과적영향.방법 장행부과수술환자80례수궤분위C조화S조,매조40측.량조적마취진통방법분별위:C조0.5％라고잡인3 ml요마,경막외수차제량위서분태니7.5μg희석성3ml;S조0.5％라고잡인3 ml+서분태니2.5 μg/ml요마,경막외수차제량위생리염수3 ml.진통빙적배제균위:0.125％라고잡인+서분태니0.5 μg/ml,배경제량2ml/h,단차급약제량위2ml,쇄정시간위30min.관찰병기록진통효과、진통약적사용량이급불량반응.결과 C조여S조상비VAS평분고화BCS평급저,S조재술후4、8、12、24 h적동통객관평분교C조저,C조PCEA기간적경외총진약량[( 120.47±10.58) ml vs.(104.15±7.83) ml]비S조대,C조환자D1/D2비치대우5적비례(17.5％vs.5.0％)고우S조,S조불량반응소우C조.결론 서분태니복합라고잡인요마초전진통능감경술후동통,제고환자적서괄도,감소술후경막외진통약적수구량,차불량반응발생솔저.
Objective To observe the effect of preemptive analgesia with sufentanil plus spinal anesthesia with ropivacaine on postoperative epidural analgesia.Methods 80 women undergoing gynecilogical surgery were randomly divided into groups C and S, 40 women for each group.Group C received 0.5％ ropivacaine of 3 ml and group S received 0.5％ ropivacaine of 3 ml plus sufentanil of 2.5 μg/ml.The formula in group C was sufentanil of 7.5 μg diluted to 3ml and that in group S was NS of 3ml.Analgetic solution for PCA was 0.125％ ropivacaine plus sufentanil of 0.5 μg/ml,background dose was 2ml/h; PCA bolus dose was 2 ml,and lockout time was 30 min.The analgesic effect,total dosage during PCA,and adverse reactions were observed.Results VAS scores were higher and BCS scores were lower in group C than in group S.The scores for postoperative pain on hours 4,8,12,and 24 hour were lower in group S than in group C.The D1/D2radio of more than 5 was greater in group C than in group S.The total dosage during PCA was larger in group C than in group S.The adverse reactions were fewer in group S than in group C.Conclusions Preemptive analgesia with sufentanil plus spinal anesthesia with ropivacaine can relieve postoperative pain,increase comfort in patients,reduce the total dosage ofPCA,and decrease the incidence of adverse reactions.
