不同浓度的舒芬太尼复合罗哌卡因对剖宫产术后硬膜外镇痛效果的比较

目的:比较3种不同浓度的舒芬太尼复合罗哌卡因用于剖宫产术后硬膜外自控镇痛(PCEA)的效果。方法:选择150例择期行剖宫产的孕妇,随机分为3组,3组在0.15%罗哌卡因的基础上分别加用舒芬太尼0.4g/mL(A组)、0.5g/mL(B组)、0.6g/mL(C组)。观察记录3组孕妇的总用药量、追加次数、各时点视觉模拟评分、改良镇静程度(Ramsay)评分、改良运动阻滞(Bromage)评分和不良反应发生情况。结果:用药总量、追加次数和罗哌卡因总用量A组明显高于B、C两组(P<0.05),舒芬太尼总用量A组明显低于B、C两组(P<0.05),用药总量、追加次数、舒芬太尼和罗哌卡因总用量B、C两组无明显差异(P>0.05),3组各时段视觉模拟评分、改良运动阻滞评分、改良Bromage评分无明显差异(P>0.05),不良反应发生率C组高于A、B组,具有统计学差异(P<0.05),结论:0.15%罗哌卡因加用舒芬太尼0.5g/mL用于剖宫产术后PCEA安全有效,且不良反应发生率较低。

Comparison of Different Concentration Sufentanil Combined with Ropivacaine for PCEA after Cesarean Section

Objective To compare the effect of three Different Concentration Sufentanil Combined with Ropivacaine For patient-controlled epidural analgesia (PCEA) After Cesarean Section. Methods One hundred and fifty Cases of Selective Cesarean Section Were divided into three groups randomly, PCEA was done after Surgery for 48h, GroupA、Group B and Group C was given 0.15% Ropivacaine Plus 0.4 g/mL、0.5 g/mL and 0.6 g/mL Sufentanil respectively. Total dosage,bonus time, VAS Score, Ramsay Score, modified Bromage Score and adverse effect occurrence were observed. Results Total dosage, bonus time and Ropivcaine dosage of group A were higher than those of group Band C (P < 0.05), Sufentanil dosage of group A were markedly lower than those of group B and C (P < 0.05), But there was no difference in total dosage, bonus time, Sufentanil do sage and Ropivacaine dosage between two group B and C (P > 0.05), Three groups were no differrence in VAS, Ramsay score and modified Bromage score (P > 0.05), The incidence of adverse effect of group C was markedly higher than those of group A and B (P < 0.05). Conclusion 0.5 g/mL Sufentanil Combined with 0.15% Ropivacaine for PCEA after Cesarean section is safe and effective, and has lower incidence of the adverse effect.