舒芬太尼对剖宫产罗哌卡因蛛网膜下腔阻滞术后镇痛的影响

目的研究5μg舒芬太尼复合罗哌卡因鞘内注射对剖宫产术后镇痛的影响。方法将足月初产妇40例随机分为2组,R组予罗哌卡因15 mg,SR组予罗哌卡因15 mg复合舒芬太尼5μg行腰硬联合阻滞麻醉,术后硬膜外镇痛24 h,监测各时点(镇痛开始后2,4,6,8,24,36,48 h)Prince-Henry评分、Ramesay镇静评分,观察排气时间及并发症。结果 2组2,4,6 h的疼痛评分、PCA用药量、总按压与有效按压次数比较均有显著性差异(P均<0.01)3,6,48 h疼痛评分比较也有显著性差异(P均<0.05)。SR组排气时间提前,但恶心呕吐发生率高。结论 5μg舒芬太尼复合罗哌卡因蛛网膜下腔阻滞用于剖宫产手术,可使术后镇痛药量减少,镇痛持续时间延长,但有明显不良反应。

Effects of sufentanil on postoperative analgesia by subarachnoid block for cesarean section with ropivacaine

Objective It is to observe the influence of of intrathecal injection of 5 μg sufentanil combined with ropivacaine on postoperative analgesia after cesarean section.Methods Forty patients underwent cesarean section were randomly divided into 2 groups,R group accepted ropivacaine for 15 mg,and SR group accepted ropivacaine 15 mg combined with 5 μg sufentanil.All patients were administrated the mixture after the success with L3―4 spinal puncture.All patients received postoperative analgesia for 24 h using single-tube-double-pump.The VAS score,Prince-Henry score and Ramesay score were recorded at 2,4,6,8,24,36 and 48h.The exhaust time and complications were observed.Results The pain score,PCA doses,the total number of button-pressing and effective pressing at 2,4,6 h showed significant difference between both groups(P<0.01),and there was a significant difference in pain score at 36,48 h between both groups(P<0.05).The exhaust time was aheaded of schedule,but the incidence of nausea and vomiting were higher in SR group.Conclusion Sufentanil in dose of 5 μg combined with ropivacaine be used to subarachnoid block in cesarean section can lower the amount of postoperative analgesic drugs,and prolong duration of analgesia,but associate with adverse effects.