0.125%左布比卡因配伍不同浓度舒芬太尼用于剖宫产术后PECA的效果观察

doi:10.3969/j.issn.1671-7171.2016.11.022

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Abstract 【Objective】To observe the clinical effects of 0.125% Levobupivacaine with different concentrations of sufentanil on patient-controlled epidural analgesia (PCEA) after cesarean section, and to determine the suitable concentration of sufentanil for this process. 【Methods】One hundred twenty (n=120) cases of full-term, single-fetal women who elected for cesarean section in our hospital were selected as the study subjects. The women aged 23 ~ 34 years old, weighed 58 ~ 80 kg, and had ASA class of Ⅰ or Ⅱ. According to a random number table, the 120 women were evenly divided into 3 groups (n=40 cases). Groups Ⅰ, Ⅱ, and Ⅲ, respectively, were given 0.4, 0.6, and 0.8 μg/mL of sufentanil combined with 0.125% Levobupivacaine. The loading dose was 5 mL, continuous infusion dose was 2 ml, the single drug dose was 2 ml, and the locking time was 15 min. The Visual Analogue Scale (VAS) was used to evaluate the patients' degree of pain 48 h postoperative. If the VAS score was ≥4, then the PCEA was deemed as a failure. A modified Bromage scoring system was used to evaluated the lower limb movement. Serum prolactin levels before anesthesia (T₀), 24 h after surgery (T₁), and 48 h after surgery (T₂) were recorded along with the times of colostrum. The total number of PCEA uses, postoperative nausea, vomiting, lethargy, itching, low blood pressure, respiratory depression, bradycardia, urinary retention, and other adverse reactions were observed.【Results】The number of PCEA total uses, PCEA failure rate, and times of colostrum in groups Ⅱ and Ⅲ were lower than those in group Ⅰ. The serum prolactin levels of group Ⅱ and Ⅲ 24 h and 48 h after surgery were significantly higher than those of group Ⅰ, with a statistically significant difference (P<0.05). The number of PCEA uses, PCEA failure rate, times of colostrum, and the serum prolactin levels 24 h and 48 h after surgery were not significantly different between groups Ⅱ and Ⅲ (P>0.05). The modified Bromage scores and their changes in the three groups had no statistically significant differences (P>0.05). The incidence of postoperative adverse reaction of group Ⅲ was significantly higher than that of groups Ⅰ and Ⅱ the difference was statistically significant (P<0.05). The incidence of adverse reactions in groups Ⅰ and Ⅱ, however, had no statistically significant difference (P>0.05). 【Conclusion】It is determined that 0.6 ug/ml is the suitable concentration of sufentanil to use in conjunction with 0.125% levobupivacaine for PCEA after cesarean section.

Key words： Bupivacaine/AD Sufentanil/AD Cesarean Section Analgesia, Epidural

Received: 07 September 2016

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R719.8

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LI Wen- yan. Effects of 0.125% Levobupivacaine with Different Concentrations of Sufentanil on Patient-Controlled Epidural Analgesia (PCEA) After Cesarean Section[J]. JOURNAL OF CLINICAL RESEARCH, 2016, 33(11): 2147-2150,2151.

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http://www.jcr.net.cn/EN/10.3969/j.issn.1671-7171.2016.11.022 OR http://www.jcr.net.cn/EN/Y2016/V33/I11/2147

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