摘要
目的 比较不同浓度罗比卡因 (Rop)伍用吗啡 (Mor)用于子宫切除术后病人硬膜外自控镇痛 (PCEA)对通气功能的影响。方法 45例病人随机分成R1、R2 和R0 组 (n =15 ) ,镇痛药分别为 0 1%Rop、0 2 %Rop和 0 9%氯化钠配伍 0 0 1%Mor ,行术后PCEA。双盲观察比较各组通气功能并进行视觉模拟疼痛评分 (VAS)。结果 与术前相比 ,三组病人通气功能均有所下降 ,表现为VT降低 ,RR加快。其程度R0 组≥R1组 >R2 组 ,而MV则无明显变化。PCEA期间R2 组通气功能稳定。PCA泵启动后与启动前相比 ,R0 组、R1组通气功能仍有明显下降 ,R0 组变化更为明显。各组PETCO2 、SpO2 、FI EO2 等指标数值有所变化 ,但无统计学意义。R2 组镇痛效果优于R1组、R0 组。三组病人VT、RR与VAS分值有明显相关性 ,相关系数分别为 - 0 89、0 80 (P <0 0 5 )。结论 0 2 %Rop伍用低浓度Mor行PCEA镇痛效果好 ,有利于改善病人术后通气功能。
Objective To compare the ventilatory function (VF)during postoperative patient-controlled epidural analgesia (PCEA) with ropivacaine (Rop)in different concentrations combined with 0.01%morphine (Mor)after hysterectomy.Methods Forty-five patients undergoing hysterectomy were divided into group R_1,R_2 and R_0,and the three groups were respectively scheduled for PCEA with 0.1%Rop,0.2% Rop and 0.9% normal saline combined with 0.01%Mor.The VF,visual analog score (VAS)and modified bromage stage were double blindly recorded and evaluated in 3 groups at specially designed time points.Results Compared with the values before operation,the postoperative VF of the 3 groups were all declined manifested by a decrease of V_T and an increase of RR in a sequence of group R_0≥group R_1>group R_2,while the MV were not statistically changed.During PCEA,VF of group R_2 maintained stablly during PCEA,while the VF of group R_0 and R_1 decreased significantly after PCEA pump started compared with that before PCEA.The P_ ETCO_2,SpO_2,F_ I-EO_2 in 3 groups had no obvious changes.The analgesic effect of group R_2 was superior to that of group R_0 and R_1 (P<0.05).The V_T and RR had alinear relationship with VAS score (r=-0.89 and 0.80 respectively)(P<0.05).Conclusion 0.2% Rop combined with 0.01% Mor provides an excellent analgesic effect and benefits to the postopertive VF.
出处
《临床麻醉学杂志》
CAS
CSCD
2001年第4期186-188,共3页
Journal of Clinical Anesthesiology
