不同浓度及容量左布比卡因用于硬膜外术后镇痛的临床观察  

Clinical observation of different concentration and volume levobupivacaine used as extradural postoperative painkiller

作　　者：杨文科[1] 翁建东[1] 周东贤[1] 郑昭平[1] 张欢楷[1] 

机构地区：[1]广东省揭阳市人民医院麻醉科,揭阳522000

出　　处：《中原医刊》2006年第21期20-21,共2页Central Plains Medical Journal

摘　　要：目的观察三种不同浓度及容量的左布比卡因用于老年病人术后硬膜外自控镇痛的有效性及安全性。方法选择60例择期食管贲门癌开胸手术病人,随机分为三组,每组20例,0.2%左布比卡因组(Ⅰ组)、0.15%左布比卡因组(Ⅱ组)和0.1%左布比卡因组(Ⅲ组),均复合吗啡(120μg/h)和氟哌利多(0.025mg/h),速率Ⅰ组1m l/h、Ⅱ组2m l/h、Ⅲ组4m l/h。观察三组病人术后的疼痛评分,PCA按压次数与有效次数及不良反应。结果术后4、16、32、48h VAS评分,Ⅲ组与Ⅰ组比较,差异有统计学意义(P<0.05)。PCA按压次数与有效次数Ⅲ组与Ⅰ组比较差异有统计学意义(P<0.05)。恶心、呕吐、皮肤瘙痒、血压下降等不良反应差异无统计学意义(P>0.05)。结论0.1%左布比卡因4m l/h复合吗啡及氟哌利多用于老年病人开胸术后镇痛安全有效。Objective To observe the effectiveness and safety of three different concentration and volume levobupivacaine which being use a in senile patients for postoperative extradural self control pain. Methods 60 cases of esophageal and cardiac carcinoma operation through thoraeotomy were randomly divided into three groups. Each group had 20 eases,0.2% levobupinacaine group （group Ⅰ ）,0. 15% levobupivacaine group （ group Ⅱ ） and 0. 1% levobupivacaine group （ group Ⅲ ） all combine with morphine （ 120 mg/h ） and droperidol （0. 025 mg/h） speed rate, group Ⅰ 1ml/h, group Ⅱ 2ml/h, group Ⅲ 4ml/h, according to three groups postoperative pain score, PCA pressure times and effective times and side effect to evaluate. Results Postoperative 4,16,32,48h VAS evaluation and scoring group 0283 compare with group Ⅰ show prominent difference （ P 〈0.05 ） PCA pressure times and effective time also show group m had prominent difference compare with group Ⅰ （ P 〈 0.05 ）, but nausea, vomiting, skin pruritus hypotension etc side effects all without prominent difference （ P 〉 0.05 ）. Conclusion 0. 1% levobupivacaine 4mL/h combine with morphine and droperidol use in senile patient for thracotomy postoperative painkiller are effective and safety.

关 键 词：左布比卡因 硬膜外 老年 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]