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鞘内舒芬太尼超前镇痛对剖宫产术后镇痛影响的观察
Observation of the effects of preemptive analgesia by intrathecal injections of sufentanil after cesarean section surgery
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DOI:
作者:
曹爽 陈佳 何虹
Shuang Cao,Jia Chen,Hong He
作者单位:
长宁区妇幼保健院
Department of Anesthesiology, Shanghai Changning Maternity and Infant Health Hospital, Shanghai, China
关键词:
舒芬太尼 鞘内注射 超前镇痛 术后镇痛
Sufentanil; intrathecal injection; preemptive analgesia; postoperative analgesia
摘要:
目的 观察舒芬太尼鞘内超前镇痛对剖宫产术后镇痛的影响及不良反应。方法 选择120例择期腰硬联合剖宫产的病人随机分为2组:超前镇痛组合对照组。两组病人均实施鞘内注射。超前镇痛组:舒芬太尼5ug+布比卡因10mg;对照组:布比卡因10mg 。 手术结束,用注射器抽取吗啡1mg及地塞米松5mg用0.9%Nacl稀释至5ml,分别经硬膜外导管注入两组患者硬膜外腔。比较2组术后2h、4 h、6h、8 h、24 h时的视觉疼痛模拟评分(VAS)和舒适程度评级布氏评分(BCS)以及比较两组术后24h内头痛、恶心、皮肤瘙痒的这三种不良反应的发生情况。结果 两组病人年龄、身高、体重、手术时间差异无统计学意义(P>0.05)。两组患者的术后2h、4h、6h、8h、24h镇痛评分VAS评分超前镇痛组均低于对照组(P<0.01),差异有统计学意义。两组患者术后24h内不良反应发生比较:恶心、呕吐、皮肤瘙痒两组发生率经统计分析差异无统计学意义(P>0.05),两组患者术后均无一例发生呼吸抑制和寒战。结论 鞘内舒芬太尼超前镇痛组与对照组比较,术后镇痛效果更完善,且副作用两组并无差异。
Objective To observe the effects of preemptive analgesia by using intrathecal injections of sufentanil after cesarean section surgery. Methods 120 patients who were chosed to have combined spinal epidural anaesthesia for elective caesarean section were divided randomly into two groups: preemptive analgesia group and control group. Two groups were the implementation of intrathecal injection. Preemptive analgesia group: sufentanil 5ug + bupivacaine 10mg; Control group : bupivacaine 10mg. After the operation, the patients in both groups were injected by a syringe in 1mg of morphia and 5mg of dexamethasone and mix them with 0.9% Nacl to 5ml with epidural catheter into the epidural cavity of patients. To ompare the visual analogus scale(VAS) and Bruggman comfort scale(BCS)in 2 hours, 4 hours, 6 hours, 8 hours and 24 hours of the two groups and their occurrences of the three side effects - headache, nausea and skin itch. Results Differences of age, height, weight and duration of operation are of no significance (P>0.05). And comparing the VAS and Broggrmann Comfort Scale in 2, 4, 6, 8, 24 hours in the two groups. the preemptive analgesia group is lower than the control group(P<0.01). The difference is of significance. The differences between occurrences of side effects in the two groups are of no significance (P>0.05). No patients have suffered inhibition of breath. Conclusion The preemptive analgesia effects of sufentanil is better than the control group with no significant difference on the occurrences of side effects.
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