Objective To compare the analgesia and side-effects of different concentrations of sufentanil combined with 0. 125% ropivacaine during patient-controlled epidural analgesia(PCEA) for cesarean section. Methods Primiparaes undergone cesarean section with ASA I - H age 22 ~31 Yrs under combined spined and epidural anesthesia (n =60) were randomly alloca ted into three groups, PCEA was performed in each group as follows A,B,C group 0. 125% ropivacaine combined with sufentanil 0. 3,0.4 or 0. 5 μg/ml . VAS scores was used to assess analgesia at rest and during movement. The total bolus doses, PCEA but ton pressing times( effective/actual), sedation and side effects ( nausea and vomiting) were recored. Results With increasing sufentanil conaentraction VAS scores,the total bolus doses and PCEA button pressing times decreased. During the 48 hours after operation the VAS scores in group C were significantly lower than those in group A and B ( P < 0. 05 or 0. 01) the total amount of PCEA solution consumed and the actual PCEA button pressing times were significantly less in group C than in group A and B ( P < 0. 05) ,The vital signs were stable and the incidence of side-effects was low. Conclusion The combination of 0.125% ropiva caine with sufentanil 0.5μg/ml provides optimal analgesia after cesarean section without increase in the consumption of sufentanil and side effects.%目的 比较剖宫产术后不同浓度舒芬太尼复合罗哌卡因患者自控硬膜外镇痛的效果.方法 比较ASAⅠ～Ⅱ级,年龄21～32岁,腰麻硬膜外麻醉下行剖宫产的足月初产妇,术后随机分为3组(n=20),行患者自控硬膜外镇痛(rPCEA),A、B、C组术后分别用0.3、0.4、0.5μg/ml舒芬太尼复合0.125%罗哌卡因PCEA,分别于术后4、8、20、24、48h记录VAS评分,镇痛药用量,PCA的按压次数并计算PCA按压计数比,镇静及恶心、呕吐等不良反应.结果 随着舒芬太尼浓度的增加,VAS评分,镇痛药用量PCA按压次数降低,PCA按压次数比逐渐上升,术后48h之内,C组VAS评分低于A、B组(P＜0.05),B组实际PCA按压次数比高于A组(P＜0.05),C组镇痛药用量,实际PCA按压次数低于A、B组(P＜0.05),PCA按压次数比高于A组(P＜0.05),术后镇静、恶心呕吐等发生率低(P＞0.05).结论 剖宫产术后0.5μg/ml舒芬太尼复合0.125%罗哌卡因PCEA镇痛效果好,且不增加不良反应.
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