经腹子宫全切术后舒芬太尼和芬太尼自控静脉镇痛的比较

目的观察舒芬太尼用于经腹子宫全切术后静脉镇痛效果、临床副作用，并与等效价的芬太尼比较有无优越性。方法选择择期硬膜外阻滞麻醉下经腹行子宫全切术患者80例，随机分为A组（芬太尼组）40例，B组（舒芬太尼组）40例。A组给予负荷量芬太尼40μg；B组给予负荷量舒芬太尼4μg。两组均采用珠海福尼亚电子微量泵（CPE-101—200型）行自控静脉镇痛。观察术后4、8、16、24h的疼痛、镇静、恶心呕吐的评分，记录血氧饱和度、镇痛液消耗量。疼痛情况用水平视觉模拟评分法（VAS）评估，镇静程度按Ramsay评分法评估。结果与A组比较，B组各时点VAS评分普遍低于A组，但仅术后24h差异有显著统计学意义（P〈0．05）。两组患者镇静评分均无达到3分者，B组各时点Ramsay评分普遍高于A组，其中术后16、24h差异有显著统计学意义（P〈0．05）。B组患者术后各时点镇痛液消耗量普遍低于A组，其中术后16、24h差异有显著统计学意义（P〈0．05）。两组术后恶心呕吐发生率均低，其中术后4h差异有统计学意义（P〈0．05）。结论经腹子宫全切术后舒芬太尼组的静脉镇痛效果略优于芬太尼组，镇静作用亦明显高于芬太尼组，而且减少恶心呕吐等副作用的发生率。

Comparison of sufentanil and fentanyl on the self-controlled intravenous analgesia after abdominal total hysterectomy in human

Objective To compare the equivalent sufentanil and fentanyl on the self-controlled intravenous analgesia after abdominal total hysterectomy on the effect of analgesia and clinical side effect in human. Methods 80 ASA Ⅰ - Ⅱ patients received abdominal total hysterectomy under epidural anesthesia were rondomly divided into 2 groups：fentanyl group（A group,n =40） ,sufentanil group（B group,n=40）. The loading dose（A group .. fentanyl 40 μg, B group. sufentanil 4 μg） was gived after surgery. The self-controlled intravenous analgesia was performed by zhuhai fornia micro electronic infusion pump（model CPE101-200） in two groups. The score of ache, sedation and vomit, the saturation of blood oxygen, the consumption of analgesic were detected at 4 h,8 h,16 h,24 h after surgery. The score of ache were assessmented by VAS,the score of sedation were assessmented by ramsay sheet. Results The score of VAS in B group decreased generally, decreased significantly compared with A group at 24 h after surgery（P〈0.05）. Both of the score of ramsay didfft achieve 3 score,the score of ramsay in B group increased generally,increased significantly compared with A group at 16 h and 24 h after surgery（P〈0.05）. The incidence of two groups was low,B group decreased significantly compared with A group at 4 h after surgery（P〈0.05）. Conclusion The effects of analgesia and sedation of sufentanil increased significantly compared with fentanyl on the self-controlled in travenous analgesia after low-segment cesarean section,the clinical side effect decreased.