氯普鲁卡因用于术后硬膜外镇痛的临床研究  

CLINICAL EFFECTS OF CHLOROPROCAINE FOR POSTOPERATIVE ANALGESIA

作　　者：傅润乔[1] 薛绵荣[1] 徐伟[1] 田鸣[2] 岳云[3] 

机构地区：[1]北京市垂杨柳医院麻醉科,北京100022 [2]北京友谊医院麻醉科 [3]北京朝阳医院麻醉科

出　　处：《中国疼痛医学杂志》2005年第4期210-213,共4页Chinese Journal of Pain Medicine

摘　　要：目的:研究国产氯普鲁卡因用于术后硬膜外镇痛的临床效果.方法: 选择30例低位横切口剖宫产、30例经腹子宫切除和45例下肢骨科手术患者,随机分为产科A1(n=15)、A2(n=15),妇科A1(n=15)、A2(n=15),骨科A1(n=15)、A2(n=15)、A3(n=15)组.术后给予硬膜外持续镇痛.A1组为1%氯普鲁卡因,A2组为1.2%氯普鲁卡因,A3组为1.2%氯普鲁卡因+2μg/ml芬太尼.结果: ①产科、妇科术后镇痛效果较好,VAS平均低于20,1.2%氯普鲁卡因更令人满意.②骨科A1组镇痛效果较差,VAS在31.1±5.9～60.6±12.4之间,有9例诉求3%氯普鲁卡因5ml+吗啡1mg 硬膜外额外用药一次,4例诉求2次.A2组VAS维持在8.1±1.5～25.7±5.8之间,明显比A1组低(P<0.01).A3组VAS则比A2组又低,且无额外镇痛诉求.③硬膜外镇痛取代硬膜外麻醉后,Bromage运动阻滞评级均为0级.结论: 氯普鲁卡因硬膜外阻滞能有效地解除术后疼痛.不同的手术应选择不同的浓度.Objective ： To investigate the analgesic effects of domestic chloroprocaine for epidural block after operation. Methods： 30 patients undergoing transverse caesarean section, 30 patients abdominal hysterectomy and 45 patients orthopaedics of lower limbs, were randomly divided into A1 （ n = 15 ） and A2 （ n = 15 ） groups of obstetrics, A1 （ n = 15 ） and A2 （ n = 15 ） groups of gynaecology, A1 （ n = 15 ）, A2 （ n = 15 ） and A3 （ n = 15 ） groups of orthopaedics. All patients were administered continuous epidural anesthesia with 1% chloroprocaine（A1 ） or 1.2% chloroprocaine（A2） or 1.2% chloroprocaine ＋2μg/ml fentanyl （ A3 ）. Results ： ① In the obstetrics group and gynaecology group the post-operative pain relief was satisfactory; Mean VAS was less than 20; 1.2% chloroprocaine had better effect. ② In orthopaedics A1, the VAS ranged from 31.1±5.9 to 60.6 ± 12.4 ; 9 patients asked for an additional epidural bolus of 3% chloroprocaine 5ml ＋ morphine lmg, and 4 patients were given twice. The VAS was 8.1 ± 1.5 25.7 ± 5.8 in orthopaedics A2, which were significantly lower （P 〈0.01 ） than that in orthopaedics A1. The VAS was even lower in orthopaedics A3 and none asked for an additional analgesic. ③ No movement disorders were observed. Conclusion： The post-operative pain could be relieved by continuous epidural anesthesia with chloroprocaine; the selected concentration levels are dependent on the kind of operation.

关 键 词：手术后 镇痛 硬膜外 氯普鲁卡因 术后硬膜外镇痛 临床研究 术后镇痛效果 硬膜外持续镇痛 横切口剖宫产 经腹子宫切除 

分 类 号：R614[医药卫生—麻醉学]