摘要
目的观察低浓度罗哌卡因硬膜外术后镇痛的临床效果。方法择期子宫切除手术患者60例,随机分为3组(n=20)。A、B组分别用0.125%罗哌卡因和0.125%布比卡因+2mg吗啡+氟哌利多5mg/100ml进行硬膜外镇痛(PCEA),C组术后疼痛时按需肌注哌替定。对比术后镇痛效果,并分别于麻醉前、切皮后90分钟、术后1、2、3天抽取外周静脉血测定血糖、胰岛素、皮质醇、肾上腺素浓度。结果A组术后运动评分明显优于B组(P<0.05)。3组于切皮后90分钟血皮质醇、血糖浓度均升高,但A组低于B、C两组(P<0.05)。结论0.125%罗哌卡因复合小剂量吗啡用于术后镇痛,效果确切,运动神经阻滞轻微,优于同等浓度布比卡因。
Objective TO investigate the effects of patient- controlled epidural analgesia（PCF.A） on endocrine function alter abdominal hysterectomy. Methods Sixty patients, scheduled for elective abdominal hysterectomy, ASA gradeⅠ -Ⅱ, were assigned randomly into three groups with 20 cases each. All three groups received the same subarachnoid space combine epidural block anesthesia. After operation PCEA was applied in group A （0. 125% ropivacaine 100ml including morphine 2mg and droperidol 5mg）and in group B（0.125% bupivacaine 100ml including morphine 2mg and droperido 5mg）, and in group C pethidine was given intermittently.The levels of blood glucose （GLU）, cortisol（Col）, insulin （INS） and epinephrine（E） were observed at five time points： before anesthesia, at 90 min alter incision, at 6h after the end of surgery, on the 1st, 2nd and 3rd postoperative days. Results The effect of analgesia were satisfaction in group A and B, but it was below the mark in group C. The levels of blood glucose and cortisol were increased significantly at 90min after incision and kept at the high levels till the 3rd postoperative day in three groups, but it was lower in group A than in group B and C（ P 〈 0.05）. Conclusion The effect of combined low concentration ropivacainr with morphine on PCEA after abdominal hysterectomy is satisfactory,with little effects for nervus motorius, it can improve the postoperative recovery.
出处
《宁夏医学杂志》
CAS
2006年第4期249-251,共3页
Ningxia Medical Journal
关键词
镇痛
罗哌卡因
子宫切除
Postoperative analgesia
PCEA
ropivacaine
abdcminal hysterectcmy
