Objective To investigate the effect of preemptive analgesia with ropivacaine mesylate and sufentanil on postoperative pain after radical surgery for ovarian cancer. Methods Twenty-four ovarian cancer patients (ASA Ⅰ -Ⅱ ) who consented to undergo radical hysterectomy and pelvic lymphadenectomy were randomly divided into two groups,with 12 patients in each group. Patients in group A were given fractionated injection of 10 mL of 0. 239% ropivacaine mesylate and 0. 5 jug · kg-1 sufentanil mixture into the epidural space at 20 minutes before anaesthesia induction, and were treated with 10 mL epidural saline infusion at the time of peritoneal closure. Patients in group B were given 10 mL epidural saline infusion at 20 minutes before anaesthesia induction, and were treated with fractionated injection of 10 mL of 0. 239% ropivacaine mesylate and 0. 5 μg · kg-1 sufentanil mixture at the time of peritoneal closure. Postoperative recovery,analgesic effect and analgesic safety were observed in both groups. Results There were no significant differences in visual analog scale (VAS) scores at rest between the two groups at 4,8,12 and 24 hours after operation (P>0. 05) , but the VAS scores in group A were obviously lower than those in group B at 48 and 72 hours after operation (P<0. 05). The differences in VAS scores at the time of postoperative cough were not significant between the two groups at 4 hours after operation (P>0. 05) ,but the VAS scores in group A were obviously lower than those in group B at 8,12,24,48 and 72 hours after operation (P<0. 05). The number of patient-controlled epidural analgesia (PCEA) button press and the amount of ropivacaine mesylate in group A were significantly lower than those in group B (all P<0. 05). Times to eyes opening and extubation in group B were significantly longer than those in group A (P<0. 05). There were no significant differences in the incidence of postoperative adverse events between the two groups (P>0. 05). Conclusion Preemptive injection of 10 mL of 0. 239% ropivacaine mesylate and 0. 5μg/kg sufentanil mixture into the epidural space can effectively alleviate postoperative pain and the amount of analgesic drug use and has good analgesia efficacy and safety in patients undergoing radical surgery for ovarian cancer.%目的 观察甲磺酸罗哌卡因和舒芬太尼超前镇痛对卵巢癌根治术术后疼痛的影响.方法 选择卵巢癌行广泛性子宫全切加盆腔淋巴清扫术病人24例,ASA分级Ⅰ-Ⅱ级,将其按随机数字表法分为2组,每组12例.超前镇痛组(A组):麻醉诱导前20 min硬膜外腔分次注入0.239%甲磺酸罗哌卡因+舒芬太尼0.5 μg·kg-1混合液10 mL,关闭腹膜时硬膜外腔给予生理盐水10 mL;对照组(B组):麻醉诱导前20 min硬膜外腔给予生理盐水10 mL,关闭腹膜时硬膜外腔注入0.239%甲磺酸罗哌卡因+舒芬太尼0.5 μg·kg-1混合液10 mL.观察2组术后苏醒情况,镇痛效果评价(VAS评分),并进行安全性评估等.结果术后静息时VAS评分:2组术后4、8、12、24 h差异无统计学意义(P>0.05),A组术后48、72 h均低于B组(P<0.05).术后咳嗽时VAS评分:2组术后4 h差异无统计学意义(P>0.05),A组术后8、12、24、48、72 h均低于B组(P<0.05).PCEA有效按压次数、PCEA甲磺酸罗哌卡因用量:A组均低于B组(均P<0.05).B组病人术后睁眼时间和拔管时间比A组长(P<0.05).2组病人术后不良反应差异无统计学意义(P>0.05).结论 硬膜外腔预先给予0.239%甲磺酸罗哌卡因10 mL复合0.5 μg·kg-1舒芬太尼可有效缓解卵巢癌根治术后疼痛,也可有效减少术后镇痛药物使用量,具有良好的超前镇痛效果和安全性.
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