摘要
目的观察等效价浓度的左旋布比卡因、罗哌卡因及布比卡因用于宫颈癌病人术后硬膜外镇痛的效果和副作用。方法选择择期行宫颈癌的病人60例,ASAⅠ-Ⅱ级。随机分为左旋布比卡因组(L组),罗哌卡因组(R组)和布比卡因组(B组),每组20例。术后分别采用0.12%左旋布比卡因(L组)、0.16%罗哌卡因(R组)、0.12%布比卡因(B组)复合2.5μg/ml芬太尼,行病人自控硬膜外镇痛。观察各组术后48h内的镇痛效果、排气时间、心率、血压和不良反应。结果三组病人在术后4h,8h,16h,24h,48h的VAS疼痛评分、改良Bromage评分及不良反应发生情况,各组间比较无显著性差异(P(0.05);三组术后最早肛门排气时间差异有显著性(P(0.05),且L组和R组明显多于B组(P(0.01)。结论0.12%左旋布比卡因,0.16%罗哌卡因与0.12%布比卡因用于宫颈癌术后硬膜外镇痛,均能取得满意的镇痛效果,但0.12%左旋布比卡因与0.16%罗哌卡因较0.12%布比卡因更能有效地促进术后肠道功能的恢复,有利于术后康复。
Objective To observe the paregoric effect and side effect of levobupivacaine, ropivacaine and bupivacaine at the same potency concentration in the patient-controlled epidural analgesia after cervical carcinoma surgery. Methods 60 ASA Ⅰ - Ⅱ patients undergoing cervical carcinoma surgery under epidural analgesia were randomly divided into three groups, 20 eases in eaeh groups. PCEA was administered with 0.12% levobupivacaine and 2.5μg/ml fentanyl （group L ,n=20） ,0.16% ropivacaine and 2.5μg/ml fentanyl （group R ,n= 20） and 0.12 % bupivacaine and 2.5μg/ml fentanyl （group B , n= 20） respectively . The paregoric effect, the time of passage of gas by anus, heart rate, blood pressure and incidence of side effects were recorded at regular intervals after operation. Results There was no significant difference in VAS score at 4h,8h,16h,24h,48h, modified Bromage motor scale score and severity of side effects after operation（P 〉 0.05）. There was significant difference in the time of passage of gas by anus （P 〉 0.05）, and the eases in group L and group R were more than group B significantly（P 〈 0.01）. Conclusion Postoperative epidural infusion with 0.12% levobupivacaine, 0. 16% ropivacaine and 0.12% bupivacaine can provide effective analgesia. Postoperative recovery in intestine function was better in 0.12% levobupivacaine group and 0.16% ropivacaine group than that in 0.12% bupivacaine group.
出处
《实用肿瘤学杂志》
CAS
2008年第3期233-236,共4页
Practical Oncology Journal
关键词
宫颈癌
硬膜外镇痛
左旋布比卡因
Cervical carcinoma
Epidural analgesia
Levobupivacaine
