罗哌卡因复合舒芬太尼用于妇科手术硬膜外麻醉效果观察

目的探讨罗哌卡因复合舒芬太尼用于妇科手术硬膜外麻醉的效果,并与罗哌卡因单独使用的效果进行对比。方法将60例择期妇科手术患者随机分为两组,即S组与R组,S组为罗哌卡因复合舒芬太尼组(n=30),R组为罗哌卡因单独使用组(n=30),两组均于L1～2间隙行硬膜外穿刺,S组予0.75%罗哌卡因15 mL复合舒芬太尼20 ug,R组予0.75%罗哌卡因15 mL。首次注药后记录两组的起效时间、感觉阻滞达最高平面时间、感觉阻滞持续时间、运动阻滞起效时间、运动阻滞持续时间,并对两组Bromage分级及麻醉效果进行比较。结果 R组与S组两组患者年龄、体质量、身高、手术及麻醉时间等一般资料经比较差异无统计学意义(P>0.05),具有可比性。S组起效时间和感觉阻滞达到最高平面的时间较R组明显缩短,感觉阻滞持续时间较R组明显延长,差异有统计学意义(P<0.05)。R组与S组两组间运动阻滞起效时间及持续时间、Bromage分级间差异无统计学意义(P>0.05)。S组麻醉效果优于R组(P<0.05)。结论 0.75%罗哌卡因15 mL含20 ug舒芬太尼用于妇科手术硬膜外麻醉的效果要优于单纯使用0.75%罗哌卡因15 mL,其用于妇科术后硬膜外镇痛效果满意,运动阻滞程度更轻,不良反应少,值得临床推广使用。

Epidural Anesthesia Effect Observation of Ropivacaine Combined with Sufentanil for Gynecological Surgery

Objective To Observe and compare the effect of ropivacaine combined with sufentanil epidural anesthesia for gyneco- logical surgery and effect with ropivacaine alone. Methods Sixty patients undergoing elective gynecological surgery patients were randomly divided into two groups, namely S group and the R group, S group was used ropivacaine combined with sufentanil group （n=30）, R group for ropivaeaine alone group （n = 30）, the two groups are injected in L1-2 epidural gap line S group to 0.75% ropi- vacaine combined with sufentanil 20 ug, R group was used to 0.75% ropivacaine 15 mL . Recorded the onset time, sensory block time, duration sensory block time , motor block onset time, motor block duration, Bromage grade and anesthetic. Results The dif- ferences of age, body weight, height, surgery and anesthesia time R group and S group patients were not statistically significant （P〉 0.05）. The onset time and sensory block to reach the highest plane of the time of R group were shorter duration of sensory block was significantly longer than the R group, the difference was statistically significant （P〈0.05）. Motor block onset time and duration Bromage grading were no difference （P〉 0.05） two groups. The anesthesia of group S was better than the R group （P〈0.05）. Con- clusion The effect of epidural anesthesia with 0.75% ropivacaine combined with sufentanil for gynecological surgery is superior to simply using 0.75% ropivacaine for gynecological postoperative epidural town satisfied with the effect of pain, degree of motor block, lighter, less adverse reactions,which is worthy of clinical use.