舒芬太尼与芬太尼在分娩镇痛中的效果比较

目的比较等效的舒芬太尼和芬太尼复合罗哌卡因对分娩镇痛的效果。方法选择初产妇60例,随机分为舒芬太尼组(S组)和芬太尼组(F组),S组PCEA输注含0.10%罗哌卡因和0.5μg/ml舒芬太尼复合液,F组PCEA输注含0.10%罗哌卡因和3μg/ml芬太尼。观察记录测麻醉前、PCEA后5、15、30、60和90min时视觉模拟评分(VAS);每小时罗哌卡因的用量和有效按压次数、运动功能的评估和不良反应等指标。结果 S组和F组在PCEA后5、15、30、60和90min时VAS评分均明显低于麻醉前(P<0.05),在各时间点S组VAS评分稍低于F组(P>0.05);每小时罗哌卡因消耗量S组明显低于F组(P<0.05),有效PCEA次数S组明显低于F组(P<0.05);两组运动阻滞和不良反应无明显差异(P>0.05)。结论 0.1%罗哌卡因复合0.5μg/ml舒芬太尼和3μg/ml芬太尼用于PCEA分娩镇痛都是有效的,但是0.5μg/ml舒芬太尼复合0.1%罗哌卡因镇痛效果更好,罗哌卡因用药量更少。

Comparison of sufentanil and fentanyl for epidural labor analgesia

Objective To compare the efficacy between fentanyl and sufentanil combined with ropivacaine for patient Controlled epidural analgesia(PCEA) in laboring women.Methods Sixty primiparas were randomly divided into sufentanil(S) group and fentanil(F) group.Group S received 0.10% ropivacaine with 0.5 μg/ml sufentanil and group F received 0.10% ropivacaine with 3 μg/ml fentanyl.Visual analogue pain score(VAS) before anesthesia and 5min,15min,30min,60min and 90min after PCEA were recorded.And need of ropivacaine consumed per hour,motor block and side effects were recorded.Results VAS in the group S and the group F during 5min,15min,30min,60min和90min after PCEA were lower than before aneshesia(P<0.05).VAS in the group S was lower than in the group F(P>0.05).The hourly dose of ropivacaine in the group S was significantly lower than in the group F(P<0.05).The number of the valid PCEA in the group S was less than in the group F(P<0.05).The two groups were no different in the motor block and the side effect(P>0.05).Conclusion We conclude that both 0.10% ropivacaine-fentanyl(3μg/ml) and 0.10% ropivacaine-sufentanil(0.5μg/ml) were equally effective by PCEA in providing labor analgesia.But 0.10% ropivacaine-sufentanil(0.5μg/ml) was more analgesia potent and less hourly dose than 0.10% ropivacaine-fentanyl(3μg/ml).