舒芬太尼用于剖宫产术后硬膜外自控镇痛的临床观察

目的观察不同浓度舒芬太尼用于剖宫产术后硬膜外自控镇痛的临床效果。方法 ASAⅠ～Ⅱ级腰硬联合麻醉下行剖宫产患者60例,术后给予硬膜外自控镇痛,根据舒芬太尼浓度不同随机分为两组,每组30例。Ⅰ组：舒芬太尼0.5μg/ml＋0.125%布比卡因,总量100ml;Ⅱ组：舒芬太尼0.75μg/ml＋0.125%布比卡因,总量100ml。预充混合液5ml,背景输注量3ml/h,PCEA量2ml,锁定时间20min。分别记录术后镇痛效果（疼痛视觉模拟评分VAS）、镇静情况（Ramsay镇静评分）、下肢运动情况（改良Bromage分级）及不良反应。结果Ⅱ组VAS评分明显低于Ⅰ组（P〈0.05）,有统计学意义。两组Ramsay镇静评分、下肢运动情况及不良反应无显著差异（P〉0.05）。结论舒芬太尼0.75μg/ml复合0.125%布比卡因适用于产科术后镇痛,镇痛效果满意,副作用少,值得推广。

Clinical investigation of sufentanyl with bupivacaine in PCEA after cesarean section

Objective To observe the clinical efficacy and side-effects of sufentanyl with bupivacaine used for post cesarean section patient-controlled epidural analgesia.Methods Sixty full-term nulliparous women who underwent cesarean section were included into this study,ASA Ⅰ～Ⅱ.They all received post-operative PCEA after combined spinal-epidural anesthesia（CSEA）.They were divided into two groups randomly.Patients were assigned to receive 0.5μg/ml sufentanyl＋0.125% bupivacaine（the groupⅠ,n=30） and 0.75μg/ml sufentanyl＋0.125% bupivacaine（the groupⅡ,n=30）.The PCEA settings were as follows：background infusion 3ml/h,demand bolus 2ml and lockout interval 20 minutes.The following datas were observed and collected：analgesia effects assessed by the visual analog scale（VAS）,degree of sedation scales assessed by Ramsay score,motor block assessed by Bromage Motor Score and side-effects such as nausea,vomiting and respiratory depression.Results The analgesic effect in groupⅡ was better than that in groupⅠ（P〈0.05）.There was no significant difference in the degree of sedation and the Bromage Motor Score.None of the patients in the two groups had respiratory depression.Conclusion 0.75μg/ml sufentanyl＋0.125% bupivacaine used in post cesarean section PCEA could provide safe and satisfactory analgesic effect,while without increasing side-effects.