罗哌卡因复合舒芬太尼用于开胸手术后硬膜外镇痛的临床观察

摘要

目的:探讨罗哌卡因复合舒芬太尼用于开胸手术病人术后镇痛的效果.方法:选择ASAⅠ-Ⅱ级全麻下行开胸手术的病人60例,随机分为研究组和对照组,每组30例.研究组采用罗哌卡因复合舒芬太尼术后镇痛,给予0.2%罗哌卡因加0.6μg/mL舒芬太尼硬膜外连续输注,单次给药剂量0.5mL,锁定时间15min,背景剂量为2.0mL/h;对照组采用吗啡0.5mg/mL静脉自控镇痛,背景剂量1.0mL/h,锁定时间5min,单次给药0.5mL.记录两组患者48h VAS评分,24、48h肺功能和血气分析情况,主要不良反应等.结果:研究组与对照组48hVAS评分无显著性差异(P>0.05).研究组术后24、48h肺功能显著优于对照组,氧分压显著高于对照组(P<0.05).对照组副反应发生情况高于研究组(P<0.05).结论:罗哌卡因复合舒芬太尼用于开胸手术硬膜外镇痛副作用较少,可明显改善肺功能,临床效果较好.%Objective: To explore the analgesic effects of ropivacaine combined with sufentanil on patinents after thoracotomy. Method: The 60 patients after thoracotomy were randomly divided into 2 groups ( n = 30), the experimental group and control group. Afte surgery ,0.2％ ropivacaine combined with 0.6 μg/mL sufentanil were continuously infused into the control group, single dose 0. 5mL within 15min , background dose of 2.0mL/h. 0.5mg/mL, lockout time 5min, background dose 1.0mL/h, After 24h,48h, VAS score ,pulmonary function, blood gas analysis and the main adverse reactions were recorded. Result: Compared with controls ,the pulmonary function and PaO2 of the experimental group were significantly higher (P＜0.05 ) ,the main adverse reactions were significantly lower( P＜0.05 ) ,while the 48h VAS score were not affected (P＞0.05). Conclusion: Ropvacaine combined with sufentanil were used on patients by epidural injection, can significantly improve pulmonary function and low adverse reactions .