不同浓度甲磺酸罗哌卡因复合舒芬太尼用于妇科术后硬膜外镇痛临床观察.docVIP

不同浓度甲磺酸罗哌卡因复合舒芬太尼用于妇科术后硬膜外镇痛的临床观察 　　【摘要】 目的 比较不同浓度甲磺酸罗哌卡因复合舒芬太尼用于妇科手术术后硬膜外自控镇痛(PCEA)的临床效果及安全性。方法 48例择期行腹式全子宫切除术的患者,术后随机分成3组,分别使用O.134%、0.178%、0.238%甲磺酸罗哌卡因复合0.5 mg/L舒芬太尼进行硬膜外镇痛并依次标志为Ⅰ、Ⅱ、Ⅲ组。记录VAS评分、改良Bromage评分和Ramsay评分并监测生命体征及观察不良反应。结果 术后4、12、24、48 h VAS 评分Ⅰ组明显高于Ⅱ、Ⅲ组(JP0.05,P0.01),术后4、12、24 h Ramsay镇静评分Ⅱ、Ⅲ组高于I组(P0.05),术后8、24 h Bromage评级Ⅲ组高于Ⅰ、Ⅱ组,均无明显不良反应。结论 0.178%甲磺酸罗哌卡因复合0.5 mg/L舒芬太尼用于妇科手术后硬膜外镇痛具有镇痛效果确切,不良反应少,为妇科手术一种较理想的镇痛方法。? 　　【关键词】 甲磺酸罗哌卡因;舒芬太尼;硬膜外;术后镇痛 　　 　　Clinical observation on epidural analgesia of postoperative gynecology by different strength Ropivacaine mesylate injection combined with Sufentanil intravenous injection 　　 　　LI Da-feng,ZHANG Sheng-sun,XIANG Gui-ye,et al. 　　Department of Anesthesiology, Yangjiang People’s Hospital, Guangdong 529500, China 　　 　　【Abstract】 Objective To compared the clinical efficacy and security of postoperative gynecology PCEA by different strength ropivacaine mesylate injection combined with sufentanil intravenous injection. Methods 48 cases of abdominal hysterectomy were selected. The patients were divided into three groups(Ⅰ group,Ⅱ group,Ⅲ group) randomly after the operation. The epidural analgesia was made by using the 0.134%、0.178% and 0.238% ropivacaine mesylate injection respectively combined with 0.5 mg/L sufentanil intravenous injection.Recorded VAS score, modified bromage score and ramsay score, monitored vital signs and observed the adverse reactions of the patients. Results The VAS score of groupⅠwas higher obviously than that of groupⅡ、Ⅲ(JP0.05,P0.01) at 4、12、24、48 hours after the operation. The Ramsay scores of groupⅡ、Ⅲ were higher than that of groupⅠ(P0.05) at 4、12、24 hours after the operation. Compared with groupⅠ、Ⅱ,the Bromage score of groupⅢ was higher at 8、24 hours after the operation. There was no obvious adverse reactions after the operation in each group. Conclusion The epidural analgesia efficacy of postoperative gynecology is exactly and the adverse reactions are a little by using 0.178% ropi