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-论文.pdf

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1、956实用医学杂志2014年第30卷第6期·药物与临床·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卢钊楷黄建忠符紫艺韩全国刘永宏王智钧谭素云摘要目的：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9O例随机分为三组，对照组(D)在硬膜外2％利多卡因3mL试用量后给予1％罗哌卡因0．2mL／kg，实验1组(SI)在对照组基础上给予10g舒芬太尼，实验2组(s2)在对照组基础上给予20g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

2、，感觉阻滞持续时间长，OAA／S评分更优，与D组比较，P<0．叭，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SPO：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．值得临床推广关键词芬太尼；罗哌卡因；硬膜外阻滞：全子宫切除术ImpactofsulfentanylonropivacaineepiduralblockduringabdominalpanhysterectomyLUZHA0一kai，HUA

3、NGJian—zhong，刚一yi，HANQuan—guo，LIUYong—hong，WANGZhi~un，TANSU-yun．DepartmentofAnesthesiology，HospitalofHoujieCounty，Dongguan523945，China【Abstract】ObjecfiveToexploretheimpactofsulfentany

4、onsufentanilepiduralblockduringabdominalpanhysterectomy．Methods90patientsscheduledforpanhysterectomywererandomly

5、dividedintothreegroups．Tthecontrolgroupreceivedepiduraladministrationof1％ropivacaineof0．2mL／kgafter2％idocaineof3mL．whilethestudygroup1received10Ixgsufentanilandthestudygroup2received20jxgsufentanilinadditiontothemedicationsusedinthecontrolgroup．Theanestheticeffect，changesinvitalsigns，andincidenc

6、eofadversereactionswerecomparedamongthethreegroups．ResultsIngroupS1andgroupS2．theonsetofepiduralanesthesiawasfaster，timetothehighestplaneofsensoryblockadeandtimetodegree3intheBromagscoreswerefaster，durationofsensoryblockadewaslonger，andOAA／Sscorewasbetter，ascomparedwithgroupD，withsignificantstat

7、isticalsignificances(P<0．01)：andtheeffectwasbetteringroupS2thaningroupS1．Therewasnodifferenceamongthethreegroupsinadversereactions．MAP，HRandSPO2wereloweringroupsS1andS2thaningroupDduringtheprocedure，withastatisticaldifference(P<0．05)．ConclusionsProperdoseofsufentanilplaysapositiveroleinropivacai

8、neepiduralblockduringpanhysterectomy，notonlyincreasestheonsetofanesthesia，butalsomakestheanesthesticeffectbetter，andhashighersafetyItisworthpopularizingclinically．【Keywords】Sufentanil；Ropivacaine；Epiduralblock；Panhysterectom