《中国康复理论与实践》 ›› 2006, Vol. 12 ›› Issue (04): 352-354.

• 临床研究 • 上一篇    下一篇

不同浓度舒芬太尼复合布比卡因持续硬膜外输注在开胸术后的镇痛效果观察

王春; 苏跃; 耿万明; 郑晖; 刘伟; 高广阔; 胡正芳   

  1. 北京市结核病胸部肿瘤研究所麻醉科 北京市 101149
  • 收稿日期:2005-09-12 出版日期:2006-04-25 发布日期:2006-04-25

Effect of Postoperative Continuous Epidural Analgesia with Sufentanil in Different Concentrations and Combined with Bupivacaine on Pain after Thoracotomy

WANG Chun, SUYue, GENG Wan-ming, et al   

  1. The Department of Anesthesiology, BeijingTuberculosis and Thoracic Tumor Institute, Beijing 101149, China
  • Received:2005-09-12 Published:2006-04-25 Online:2006-04-25

摘要: 目的观察不同浓度舒芬太尼复合0.125%布比卡因持续硬膜外输注在开胸术后的镇痛效果和安全性。方法将30例ASAII~III级、行胸外科手术的患者随机分为3组,分别用0.125%布比卡因复合0.25μg/ml舒芬太尼(A组)、0.50μg/ml舒芬太尼(B组)和0.75μg/ml舒芬太尼(C组)。术前,于T7~T8行硬膜外穿刺置管,手术结束后接入镇痛泵行持续硬膜外输注镇痛,观察术后6h、12h、24h和48h的疼痛视觉模拟评分(VAS)、辅助药用量和镇静、恶心、呕吐、皮肤瘙痒、呼吸抑制等副作用。结果B组和C组各个时段的VAS评分和48h的辅助镇痛用药量两组间无显著性差异,但均低于A组(P<0.05)。A组和B组的瘙痒评分均低于C组(P<0.05),但两组间无显著性差异。各组均无严重的呼吸抑制发生。结论0.50μg/ml的舒芬太尼复合0.125%布比卡因持续硬膜外输注在开胸术后可取得较满意的镇痛效果且副作用较小。

关键词: 舒芬太尼, 镇痛, 硬膜外, 开胸术

Abstract: ObjectiveTo observe the effect and safety of continuous epidural analgesia with sufentanil in different concentrations combined with 0.125% bupivacaine on pain after thoracotomy.Methods30 patients with ASA grade Ⅱ~Ⅲ and underwent thoracotomy were randomly divided into 3 groups treated with 0.125% bupivacaine combined with sufentanil 0.25 μg/ml (group A), 0.50 μg/ml (group B) and 0.75 μg/ml (group C) respectively. Before operation starting, epidural puncture was performed at T7~T8 and a catheter was put in. After operation, continuous epidural analgesia was performed by connecting the catheter and a analgesic pump. Analgesia effect was evaluated by visual analogous score (VAS) at sixth, twelfth, twenty-fourth and forty-eighth hours after operation. Dosage of assistant drug and side effects such as calmness, nausea, vomiting, skin pruritus and respiratory inhibition were also recorded.ResultsVAS scores and dosage of assistant drug of group B and group C were not different, but they were all lower than that of group A (P<0.05). Scores of skin pruritus of group A and group B were lower than that of group C (P<0.05), but there was no significant difference between group A and group B. No respiratory inhibition occurred in patients of all three groups.ConclusionContinuous epidural analgesia of 0.50 μg/ml sufentanil combined with 0.125% bupivacaine is safe and effective for patients after thoracotomy.

Key words: sufentanil, analgesia, epidural, thoracotomy