不同浓度舒芬太尼用于妇科术后静脉镇痛效果的比较

目的比较不同浓度舒芬太尼用于妇科术后静脉自控镇痛(PCIA)的镇痛效果及不良反应,探讨舒芬太尼用于PCIA的安全有效浓度。方法选取90例拟在腰麻-硬膜外联合麻醉下行妇科手术的患者,ASA分级Ⅰ～Ⅱ级,随机分为A、B、C3组,每组30例。3组镇痛泵配方均为相应浓度舒芬太尼及地塞米松10mg加入0.9%氯化钠注射液至100mL。A组舒芬太尼浓度为1.5μg/kg;B组舒芬太尼浓度为2μg/kg;C组舒芬太尼浓度为2.5μg/kg。3组镇痛泵均设置为维持剂量2mL/h,首次负荷剂量3mL,单次自控剂量0.5mL,锁定时间15min。观察3组术后24、48h的镇痛评分和不良反应发生率。结果A、B、C3组患者镇痛评分比较,差异有统计学意义(P<0.05),A组镇痛效果最弱。A、B、C3组患者不良反应发生率比较,差异亦有统计学意义(P<0.05),C组不良反应发生率最高。结论浓度为2.0μg/kg的舒芬太尼用于PCIA镇痛效果确切,不良反应小,是舒芬太尼用于术后静脉镇痛的适宜浓度。

Comparison between Postoprative Analgesia with Different Concentrasion of Sufentanil in Patients Underwent Gynecologic Surgery

Objective To compare the analgesia effect and side effects of PCIA in patients underwent gynecologic surgery.To investigate the safe and effective concentration of sufentanil with PCIA.Methods Ninety patients with ASAⅠ-Ⅱ,underwent gynecologic surgery by spinal-epidural combind anesthesia were randomly divided into group A,B and C,equally with 30 cases each.Each group was given sufentanil with corresponding concentrasion plus dexamethasone 10mg diluted into 100 ml with 0.9% sodium chloride injection via PCIA.The concentrasion of group A was 1.5 μg/kg;group B was 2 μg/kg;group C was 2.5 μg/kg.Of each group,the PCIA rate was 2ml/h,first blous 3ml,PCIA blous 0.5ml,lock time 15 min.Analgesia grade were accessed and side effects were recorded.Results There is a significant statistical difference in the analgesia effects of the 3 groups(P<0.05).The analgesia effect of group A was insufficient compared with group B and group C.There is also a significant statistical difference in the side effects incidence of the 3 groups(P<0.05).The side effects incidence were higher in group C than both group A and group B.Conclusion The concentrasion of 2.0 μg/kg sufentanil in has sufficient analgesia effect and lower side effects,is the appropriate concentrasion of sufentanil in PCIA.