目的：研究舒芬太尼对腹式全子宫切除术罗哌卡因硬膜外阻滞效应的影响。方法：选择拟行腹式全子宫切除术的患者90例随机分为三组，对照组（D）在硬膜外2％利多卡因3 mL 试用量后给予1％罗哌卡因0．2 mL/kg，实验1组（S1）在对照组基础上给予10μg 舒芬太尼，实验2组（S2）在对照组基础上给予20μg舒芬太尼。对比观察三组麻醉效果，生命体征变化及不良反应发生率。结果：S1，S2组硬膜外起效、达到感觉阻滞最高平面、达到Bromag 评分为3的时间快，感觉阻滞持续时间长， OAA/S 评分更优，与 D 组比较，P ＜0．01，差异显著有统计学意义，且 S2组比 S1组效果更佳。三组不良反应差异无统计学意义。 S1， S2组患者术中 MAP、HR 和 SPO2均低于 D 组，P ＜0．05，差异有统计学意义。结论：合适剂量的舒芬太尼对全子宫切除术罗哌卡因硬膜外阻滞效应具有加强的作用，加快麻醉起效，使麻醉效果更佳，具有较高的安全性，值得临床推广。%Objective To explore the impact of sulfentanyl on sufentanil epidural block during abdominal panhysterectomy. Methods 90 patients scheduled for panhysterectomy were randomly divided into three groups. Tthe control group received epidural administration of 1% ropivacaine of 0.2 mL/kg after 2% idocaine of 3 mL , while the study group 1 received 10μg sufentanil and the study group 2 received 20μg sufentanil in addition to the medications used in the control group. The anesthetic effect, changes in vital signs, and incidence of adverse reactions were compared among the three groups. Results In group S1 and group S2, the onset of epidural anesthesia was faster , time to the highest plane of sensory blockade and time to degree 3 in the Bromag scores were faster , duration of sensory blockade was longer , and OAA/S score was better , as compared with group D , with significant statistical significances (P<0.01);and the effect was better in group S2 than in group S1. There was no difference among the three groups in adverse reactions. MAP , HR and SPO2 were lower in groups S1 and S2 than in group D during the procedure, with a statistical difference (P<0.05). Conclusions Proper dose of sufentanil plays a positive role in ropivacaine epidural block during panhysterectomy , not only increases the onset of anesthesia, but also makes the anesthestic effect better, and has higher safety It is worth popularizing clinically.
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