鞘内注射舒芬太尼对剖宫产术后镇痛效果的研究

评价舒芬太尼鞘内注射对剖宫产术后镇痛效果。方法：将90例择期腰-硬联合麻醉行剖宫产产妇随机等分为三组。术时用药,A、C组：罗哌卡因15 mg＋0.9%生理盐水0.5 ml＋10%葡萄糖1 ml;B组：罗哌卡因15 mg＋舒芬太尼5μg（0.5 ml）＋10%葡萄糖1 ml。术后用药,A、B组：0.16%罗哌卡因＋0.002 5%氟比利多;C组：0.16%罗哌卡因＋0.002 5%氟比利多＋0.005%（5 mg）吗啡。设置：无负荷量,2 ml/h,PCA：1 ml,锁定时间：15 min,术毕开启,镇痛24h。专人术后2、4、6、8、24、36、48 h用VAS和Prince-Henry方法进行疼痛评分、记录用药量、PCA按压次数。结果：B组比A、C组起效时间缩短（P〈0.01）,A、C组在术后2、4、6 h评分差异无显著性,但高于B组（P〈0.01）,三组在8、24 h评分差异无显著性,在36、48 h两个时点A、C组评分均高于B组（P〈0.01）。结论：鞘内注射舒芬太尼用于剖宫产术后镇痛,缩短麻醉起效时间,镇痛效果明显,8后镇痛效果减弱但持续时间较长,有一定的副作用。

Study on Postoperative Analgesia Effect by Intrathecal Sufentanil Injection in Caesarean Sections

Objective：To evaluate the effect of intrathecal sufentanil injection on postoperative analgesia in gaesarean sections. Methods ：Ninety ASA Ⅰ-Ⅱ pregnant women for elective caesarean section under combined spinal and epidural anesthesia were randomly divided into 3 groups with 30 cases each. Patients were injected preoperatively intrathecally with ropivacaine 15 mg,0.9%NS 0.5 ml and 10% glucose 1 ml in group A and C,Ropivacaine 15 mg,sufentanil 5 μg（0.5 ml） and 10% glucose 1 ml in group B,after operation,patients in group A and B were given 0.16% ropivacaine and0. 002 5% droperidol in the PCA Bump,the group C appended 0. 005M（5 mg） morphine. PCA Bump was intercalated：No load dosage ＋basal dosage 2 ml＋1 ml/per time＋locktime 15 min. VAS and Prince-Henry methods were used postoperatively to evaluate pain feeling in 2、4、6、8、24、36 and 48 h. Results：The onset time of the sensory block in guoup B was shorter than group A￡C （P〈0.01）,but,which were higher than in group B（P〈0.01）. There were no signicant differences between three groups in 8、24 h. While the scores in 36 h and 48 h in group A and group C were higher than group B （P〈0.01）. Conclusion：Intrathecal injection sufentanil on preemptive analgesia in gaesarean sections can not only short the time of sensory block but also provide satisfactory postoperative analgesia. The effects of 8h after postoperative analgesia are attenuater,but last time are longer,it has many side effects yet.