摘要
目的 :研究不同浓度的罗哌卡因复合芬太尼用于下腹部手术术后PCEA的镇痛效果和不良反应。方法 :4 0例ASAⅠ～Ⅱ级全子宫切除手术患者 ,随机分成R1组与R2 组。术后均采用PCEA治疗。R1组用 0 .15 %罗哌卡因 +芬太尼 2 μg/ml+氟哌利多 1.2 5 μg/ml;R2 组用 0 .2 %罗哌卡因 +芬太尼 2 μg/ml+氟哌利多 1.2 5 μg/ml。镇痛时间术后 4 8h。PCEA设置 :负荷量 6ml,bolus5ml/次 ,锁定时间 2 0min ,4h限量 4 0ml。镇痛效果和副作用评定 :( 1)采用视觉模拟评分 (VAS)。 ( 2 )记录不良反应。结果 :两组镇痛效果相似 (P >0 .0 5 ) ,但运动神经阻滞的程度不同 ,R2 组明显强于R1组 (P <0 .0 5 =。两组副作用均较轻。结论 :浓度为 0 .15 %罗哌卡因 - 2 μg/ml芬太尼用于下腹部手术PCEA的镇痛效果良好且运动神经阻滞发生少 ;
Objective:To compare the analgesic and side effect of patient-controlled epidural analgesia with two different solutions of ropivacaine/fentanyl after hysterectomy.Methods:Forty ASA Ⅰ-Ⅱ patient undergoing elective hysterectomy under epidural anesthesia were randomly divided into two groups:0.15% ropivacaine- 2μg/ml fentany group (R 1, n =20) and 0.2% ropivacaine-2 μg/ml fentanyl group (R 2, n =20).Patient- controlled epidural analgesia setting for the two solutions:the loadinding doses was 6ml,bolus dose was 5ml,lock-out interval time 20 min and maximal amount within 4 h was 40ml in both groups.The clinical effects were assessed by(1)VAS score of pain (0=no pain,10=severe pain),(2)modified Bromage score,(3)monitoring heart rate and blood pressure after preoperation and analgesia,(4)the time when the patient passed gas and(5)side effect (nausea,vomiting,motor block et al).Results:All two solutions produced equivalent analgesia.Motor block was significantly more common and more intense with the 0.2% ropivacaine-2μg fentanyl solution.Other side effects were equivalent between solutions and mild. Conclution:Our results suggest that 0.15% ropivacaine -2μg fentanyl solution for postoperative PCEA after lower abdominal surgery provides satisfactory analgesia and less motor block.
出处
《重庆医科大学学报》
CAS
CSCD
2004年第3期354-355,359,共3页
Journal of Chongqing Medical University
