吉林医学
吉林醫學
길림의학
JILIN MEDICAL JOURANL
2014年
33期
7338-7339,7340
,共3页
镇痛%剖宫产术%舒芬太尼
鎮痛%剖宮產術%舒芬太尼
진통%부궁산술%서분태니
Analgesia%Cesarean section%Sufentanil
目的：以芬太尼为对照，比较不同剂量舒芬太尼复合1.192％罗哌卡因用于剖宫产手术后硬膜外镇痛的临床效果和安全性。方法：将孕36~40周剖宫产产妇 ASAⅠ~Ⅱ选择120例，腰硬联合阻滞下行剖宫产患者，术后硬膜外镇痛随机分为三组（n =40）：A 组（芬太尼组）用芬太尼5μg/ m 复合1.192％罗哌卡因25 ml；B 组（舒芬太尼组）用舒芬太尼50μg 复合1.192％罗哌卡因25 ml；C 组（罗哌卡因）单独用1.192％罗哌卡因25 ml。三组手术结束后都静脉推注格拉司琼3 mg 止吐，术中连续监测生命体征，记录术后24 h 内的镇痛效果、不良反应及辅助药物的使用情况。镇痛效果评价采用视觉模拟评分（ Visual Analogue Scale；VAS）标准。VAS≤3分认为镇痛有效。结果：B 组在术后1 h、3 h、5 h 的静息、咳嗽和活动时镇痛效果优于 A 组、C 组（P <0.05），B 组术后24 h 恶心呕吐发生率与 A 组、C 组比较差异无统计学意义（P >0.05）；A 组瘙痒发生率与 B 组、C 组比较明显较高（P <0.05）；其他不良反应如呼吸抑制、嗜睡、心动过缓等三组间比较差异无统计学意义（P >0.05）。结论：舒芬太尼可安全有效地用于剖腹产患者术后，镇痛效果优于芬太尼，不良反应少，程度较轻。
目的：以芬太尼為對照，比較不同劑量舒芬太尼複閤1.192％囉哌卡因用于剖宮產手術後硬膜外鎮痛的臨床效果和安全性。方法：將孕36~40週剖宮產產婦 ASAⅠ~Ⅱ選擇120例，腰硬聯閤阻滯下行剖宮產患者，術後硬膜外鎮痛隨機分為三組（n =40）：A 組（芬太尼組）用芬太尼5μg/ m 複閤1.192％囉哌卡因25 ml；B 組（舒芬太尼組）用舒芬太尼50μg 複閤1.192％囉哌卡因25 ml；C 組（囉哌卡因）單獨用1.192％囉哌卡因25 ml。三組手術結束後都靜脈推註格拉司瓊3 mg 止吐，術中連續鑑測生命體徵，記錄術後24 h 內的鎮痛效果、不良反應及輔助藥物的使用情況。鎮痛效果評價採用視覺模擬評分（ Visual Analogue Scale；VAS）標準。VAS≤3分認為鎮痛有效。結果：B 組在術後1 h、3 h、5 h 的靜息、咳嗽和活動時鎮痛效果優于 A 組、C 組（P <0.05），B 組術後24 h 噁心嘔吐髮生率與 A 組、C 組比較差異無統計學意義（P >0.05）；A 組瘙癢髮生率與 B 組、C 組比較明顯較高（P <0.05）；其他不良反應如呼吸抑製、嗜睡、心動過緩等三組間比較差異無統計學意義（P >0.05）。結論：舒芬太尼可安全有效地用于剖腹產患者術後，鎮痛效果優于芬太尼，不良反應少，程度較輕。
목적：이분태니위대조，비교불동제량서분태니복합1.192％라고잡인용우부궁산수술후경막외진통적림상효과화안전성。방법：장잉36~40주부궁산산부 ASAⅠ~Ⅱ선택120례，요경연합조체하행부궁산환자，술후경막외진통수궤분위삼조（n =40）：A 조（분태니조）용분태니5μg/ m 복합1.192％라고잡인25 ml；B 조（서분태니조）용서분태니50μg 복합1.192％라고잡인25 ml；C 조（라고잡인）단독용1.192％라고잡인25 ml。삼조수술결속후도정맥추주격랍사경3 mg 지토，술중련속감측생명체정，기록술후24 h 내적진통효과、불량반응급보조약물적사용정황。진통효과평개채용시각모의평분（ Visual Analogue Scale；VAS）표준。VAS≤3분인위진통유효。결과：B 조재술후1 h、3 h、5 h 적정식、해수화활동시진통효과우우 A 조、C 조（P <0.05），B 조술후24 h 악심구토발생솔여 A 조、C 조비교차이무통계학의의（P >0.05）；A 조소양발생솔여 B 조、C 조비교명현교고（P <0.05）；기타불량반응여호흡억제、기수、심동과완등삼조간비교차이무통계학의의（P >0.05）。결론：서분태니가안전유효지용우부복산환자술후，진통효과우우분태니，불량반응소，정도교경。
Objective WIth fentanyl as control,comparison of different doses of sufentanil combined with 1. 192% ropivacaine for ce-sarean section clinical efficacy and safety of epidural analgesia after operation. Method The pregnant 36 ~ 40 weeks after cesarean section ASA Ⅰ ~ Ⅱ 120 cases,spinal and epidural anesthesia in caesarean section patients,postoperative epidural analgesia were randomly divided into three groups(n = 40):A group(fentanyl group)fentanyl 5 μ g/ m ropivacaine 1. 192% 25ml;group B(sufentanil group). Fentanyl 50 μg ropivacaine 1. 192% 25ml;group C(ropivacaine)25 ml ropivacaine 1. 192% alone. The end of the three groups after operation were intravenous granisetron 3mg antiemetic,vital signs were monitored continuously,recording the use of analgesic effect,within 24 hours of the postoperative adverse reaction and auxiliary drug. Evaluation of analgesic effect using a visual analogue score(Visual Analogue Scale;VAS) standard. VAS score ≤ 3 think effective analgesia. Results In B group,after 1 h,3 h,5h resting,cough and activities of the analgesic effect was better than A group,C group(P < 0. 05),B group 24h after the incidence of nausea and vomiting with group A,group C had no signifi-cant difference(P > 0. 05);the incidence of pruritus in A group were significantly higher than that of group B and group C(P < 0. 05);oth-er side effects such as respiratory depression,lethargy,Beckoning had no difference between the three groups,the differcen wasn't statisti-cally significant(P > 0. 05). Conclusion Sufentanil can be used safely and effectively in patients with cesarean section,the analgesic effect of sufentanil is superior,to fentanyl,it has a less adverse reaction and lesser extent.
