局麻药液中加入芬太尼对硬膜外麻醉效果的影响  

Effects of Fentanyl Added to Local Anesthetics on the Efficacy of Epidural Anesthesia

作　　者：谭天云 胡兴国[1] 刘菊芳[1] 肖亚芬 白国建 石珍珍[1] 

机构地区：[1]湖南省桃源县人民医院

出　　处：《医学临床研究》2003年第12期901-903,共3页Journal of Clinical Research

摘　　要：目的探讨局麻药液中加入芬太尼对硬膜外麻醉效果的影响及芬太尼最佳剂量。方法将 4 5例择期妇科手术病人 ,根据硬膜外局麻药液中所含芬太尼剂量不同 ,随机分为A、B、C三组 :即分别在 0 .75 %布比卡因 1 5ml中加入①生理盐水 2ml;②芬太尼 5 0 μg和生理盐水 1ml;③芬太尼 1 0 0 μg ,使 1 7ml局麻药液中B、C组分别含芬太尼 2 .94和 5 .8μg/ml。观察三组麻醉效果、副作用发生率及术后肛门排气、排便时间。结果与A组比较 :B组、C组的麻醉起效时间、运动阻滞起效时间明显缩短 (P均 <0 .0 5 ) ;C组感觉阻滞平面升高 ,术后镇痛时间则明显延长 (P <0 .0 5 )。C组与B组之间 ,上述指标差异亦有显著性 (P <0 .0 5 )。三组间副作用发生率、肛门排气、排便时间无明显区别。结论局麻药液中加入芬太尼能提高硬膜外麻醉效果 ,其剂量以 5 .ObjectivesTo investigate the effects of Fentanyl added to local anesthetics on the efficacy of epidural anesthesia and the optimum dosage of fentanyl.MethodsForty five patients underwent selective gynecological operations were randomly divided into three groups according to different dosage of fentanyl added to local anesthetics ① Group A, 2ml normal saline (NS) plus 15ml of 0.75% bupivacaine was given;②Group B, 50 mg fentanyl and 1ml NS plus 15ml of 0.75% bupivacaine (i.e.fentanyl 2.94 mg/ml) was administered;③Group C,100 mg fentanyl in 15 ml of 0.75% bupivacaine (i.e. fentanyl 5.88 mg/ml) was injected.The efficacy of epidural anesthesia, incidence of its side effects and the time of anal exhaust and evacuation after operation were observed in three groups.ResultsAs compared with Group A, the onset time of anesthesia and neuromotor blockade were obviously shortened in Groups B and C (P<0.05); while the levels of sensory blockade increased and duration of postoperative analgesia distinctly prolonged in Group C (P<0.05). A significant difference in criteria mentioned above also existed between Group B and C (P<0.05) .But there were no significant differences in the incidence of side effects ,anal exhaust and time of evacuation among these three groups.ConclusionFentanyl added to local anesthetics can improve the efficacy of epidural anesthesia, Its optimum dosage without more side effects is 5.88 mg/ml.

关 键 词：麻醉 硬膜外 芬太尼 麻醉 局部 

分 类 号：R614.1[医药卫生—麻醉学]