【摘要】 目的 观察舒芬太尼复合罗哌卡因用于下肢手术后病人硬膜外自控镇痛(PCEA)的临床效果和不良反应。方法 选择60例ASAⅠ~Ⅱ级行下肢手术的病人,随机分为两组(S组和F组)各30例。术后行PCEA,采用负荷剂量(5ml)+ 持续输注背景剂量 (2ml/h)+ 病人自控镇痛(PCA)剂量(2ml/次),锁定时间20min。S组镇痛用药为0.125%罗哌卡因+0.5μg/ml舒芬太尼,F组为0.125%罗哌卡因+4μg/ml芬太尼。分别于术后4、8、20、24、48h双盲对照观察两组各时间段镇痛药的用量、PCA的实际按压次数及有效按压次数、视觉模拟评分(VAS)、生命体征以及恶心、呕吐、头晕、嗜睡、呼吸抑制和皮肤瘙痒等不良反应的发生情况。结果 两组病人总体镇痛效果满意,生命体征稳定。术后两组间各时间点VAS评分、各时间段镇痛药消耗量、PCA实际按压次数及不良反应发生率的比较均无统计学差异(P>0.05)。结论 舒芬太尼与罗哌卡因复合应用于下肢手术后的病人行PCEA,镇痛效果明确,不良反应发生率低,可为病人提供安全满意的术后镇痛。

    【关键词】 舒芬太尼 芬太尼 罗哌卡因 术后镇痛

    Application of Sufentanil Combined with Ropivacaine in Patients Controlled Epidural Analgesia after Lower Limbs Surgery

    Luo Yao,et al.

    (Department of Anesthesiology，First Affiliated Hospital,Medical School of Xi’an Jiaotong University,Xi’an,Shanxi 710061)

    【Abstract】 Objective To observe the analgesic and side effects of sufentanil combined with ropivacaine in patients controlled epidural analgesia(PCEA) after lower limbs surgery.Methods Sixty patients (ASAⅠ~Ⅱ) scheduled for the lower limbs surgery were divided randomly into two groups (S group and F group) with 30 patients each.PCEA included loading dose 5ml,bolus of 2ml with 20minutes and background 2ml/h.Group S received 0.125% ropivacaine + sufentanil 0.5μg/ml for PCEA,Group F received PCEA with 0.125% ropivacaine + sufentanil 4μg/ml.The analgesia effects was evaluated by visual analogue scales(VAS).The dose of drug,the requirements of PCA and side effects such as nausea,vomiting,swirl,respiratory depression and itch of skin were also recorded at 4,8,20,24 and 48 hour after operation.Results Both S and F group showed good pain relief.There were no significant differences in the potency of analgesi,VAS scores,the dose of drug,the requirements of PCA and side effects between two groups(P>0.05).Conclusions PCEA with sufentanil combined with ropivacaine was safe and effective for patient after lower limbs surgery. ......