摘要
目的 比较研究妇科手术后罗哌卡因 (Rop)、吗啡 (Mor)不同模式病人自控硬膜外镇痛 (PCEA)的效应。方法 选择经腹子宫全切术的病人 6 0例 (ASAⅠ～Ⅱ级 ) ,随机分成三组 ,均选双泵法。A泵镇痛液为0 2 %Rop ,B泵镇痛液为 0 0 1%Mor ;Ⅰ组 :A泵给药方法为每小时 2ml持续硬膜外输注 ,B泵以LP模式PCEA ;Ⅱ组 :A泵输注方法同Ⅰ组A泵 ,B泵以LCP模式PCEA ;Ⅲ组 :A泵输注为零 ,B泵给药方法同Ⅱ组B泵。结果 三组镇痛效果相似 ,而 2 4h硬膜外Rop药量Ⅱ组 >Ⅰ组 >Ⅲ组 ,PCEA所需的Mor剂量Ⅰ组最少。从 4h后PCA按压次数Ⅰ组 >Ⅱ组≈Ⅲ组 (P <0 0 5 ) ,术后 2h无运动阻滞的病人Ⅰ组为 40 % ,Ⅱ组为 45 % ,Ⅲ组为 76 % ,术后 4h三组病人均无运动阻滞。不良反应 :三组病人恶心呕吐发生率为 5 %～ 10 % ,无呼吸抑制。结论 Rop持续硬膜外输注时 ,吗啡PCEA以LP模式用药 ,在达到满意镇痛效应的情况下 ,能减少吗啡的消耗量 ,手术后
Objective\ The effects of 0.2% ropivacaine continuous infusion and 0.01% morphine with epidural patient-controlledl analgesia(PCA)for postoperative pain relief were compared after total hysterectomy.Methods\ 60 adult patients(ASA grade Ⅰ～Ⅱ)undergoing total hysterectomy were randomly divided into three groups,each group was performed analgesia by two pumps:group Ⅰ(n=20)with 0.2% ropivacaine-2ml/h epidural continuous infusion by Graseby 3300 pump;group Ⅱ (n=20)with 0.2% ropivacaine-2ml/h epidural continuous infusion and 0.01% morphine epidural PCA with loading dose 5ml and continuous infusion 0.5ml/h and dolus 1ml(LCP);group Ⅲ(n=20)without 0.2% ropivacaine epidural continuous infusion but 0.01% morphine epidural PCA with LCP.Results\ The analgesic efficacy in the three groups was similar.The group Ⅰ needed less morphine of epidural PCA over 24 hours than that in the group ⅡandⅢ.45% patients in the group Ⅰ and 40% patients in the group Ⅱ compared with 76% in the group Ⅲ had no motor block 2h after operation.The incidence of nausea and vomiting was between 5% to 10%,and no respiratory depression in three groups.Conclusion\ Adding low dose 0.2% ropivacaine epidural continuous infusion(2ml/h)could reduce epidural PCEA-LP mode morphine requirements over 24 hours under the condition of effective pain relief.There was no significant motor block 4h after operation.
出处
《中国实用妇科与产科杂志》
CSCD
北大核心
2000年第2期93-95,共3页
Chinese Journal of Practical Gynecology and Obstetrics
