不同浓度舒芬太尼复合罗哌卡因鞘内注射在剖宫产术后镇痛中的应用评价

目的：探讨不同浓度舒芬太尼复合罗哌卡因鞘内注射应用于剖宫产术后镇痛的有效性及安全性。方法：将1460例行剖宫产术患者随机分为A组（489例）、B组（501例）和C组（470例）。所有患者均采用腰硬联合阻滞,分别给予0.3μg/mL、0.4μg/mL、0.5μg/mL舒芬太尼配伍0.1%盐酸罗哌卡因。结果：B组、C组术后2h、8h、12h VAS评分显著低于A组,差异均有统计学意义（P〈0.05）,而该时间点B组、C组VAS评分比较则无显著性差异（P〉0.05）。三组术后24h VAS评分比较均无统计学意义（P〉0.05）。B组、C组术后镇痛泵按压有效率较A组显著升高,差异均有统计学意义（P〈0.05）,而B组、C组比较则无显著性差异（P〉0.05）。A组和B组不良反应的发生率分别8.0%和10.2%,显著低于C组20.2%,差异有统计学意义（P〈0.05）。结论：0.4μg/mL舒芬太尼＋0.1%盐酸罗哌卡因应用于剖宫产术后镇痛,可有效缓解术后早期的疼痛,并减少不良反应。

Comparative Study of Different Concentration of Sufentanil Combined with Ropivacaine in Postoperative Analgesia after Cesarean Section

Objective： To explore the clinical effect and safety of different concentration of ropivacaine in sufentanil combined with ropivacaine in postoperative analgesia after cesarean section. Methods： 1460 patients for cesarean section were randomly divided into three groups including Group A （n=489）, Group B （n=501） and Group C （n=470）. All the patients were performed by combined spinal-epidural anesthesia （CSEA）, and given 0.1% ropivacaine combined with 0.3 μg/mL, 0.4μg/mL, 0.5 μg/mL sufentanil separately. Results： The VAS scores after cesarean section for 2h, 8h, 12h in Group B and Group C were significantly lower than that in Group A （P〈0.05）, while there was no significantly difference between B group and C group （P〉0.05）. The VAS scores after cesarean section for 24 h among three groups were no statistically different （P〈0.05）. Compared with Group A, the effective rate of PECA bump was significantly increased in Group B and Group C （P〈0.05）, while there was no significantly difference between B group and C group （P〉0.05）. The rate of side effect in Group A, Group B （8.0%,10.2%） was significantly lower than that in C group （20.2%）（P〈0.05）. Conclusions： The concentration of 0.4μg/mL sufentanil ＋0.1% ropivacaine in postoperative analgesia after cesarean section can contribute to relief early pain after operation and can reduce the side effect.