关键词: 舒芬太尼, 吗啡, 硬膜外, 术后镇痛

Abstract: Objective To evaluate the postoperative analgesic effects of sulfentanil and morphine at loading doses in patients with cesarean. Methods One hundred and twenty ASA I or II women following cesarean section, were randomly assigned to two groups(n=60 each) according to different epidural loading doses: sulfentanil 20 μg and morphine 3 mg group, then contiuous epidural infusion were given with infusion pumps as follows: 0.6 mg/L sulfentanil, 0.15% ropivacaine and 25 mg/L droperidol at infusion rate 2 mL/h. Visual analog scale(VAS), side effects and oral analgesics administration were recorded. Results There was no significant difference in pain from incision and from uterine contraction in both groups at 2~6 h and 18~24 h postoperatively(P>0.05). Pain score and analgesic requirements were higher in sulfentanil group at 7~10 h(P<0.01). Uterine contraction pain was more severe than incisal pain at 2~6 h and 7~10 h postoperatively in both groups(P<0.01). There was no significant difference in pain from incision and from uterine contraction in morphine group, while incisal pain was more severe in sulfentanil group at 18~24 h. There was more satisfaction of pain relief in morphine group(P<0.01), but more side effects of nausea, vomiting and pruritus were recorded(P<0.01). Conclusion Except the side effects, the postoperative epidural analgesic effect of morphine is better than that of sulfentanil, and both have better analgesic effect in incisal pain than uterine contraction pain.

Key words: sufentanil, morphine, epidural, postoperative analgesia