丁丙诺啡-氟哌利多硬膜外超前镇痛在胆囊切除术中应用的临床研究  

Clinical Study on the Application of Epidual Buprenorphine - droperidol Preemptive Analgesia to the Patients Undergoing Cholecystectomy

作　　者：韩业山[1] 李立[1] 

机构地区：[1]常州市第二人民医院,江苏213000

出　　处：《常州实用医学》2008年第6期354-356,共3页CHANGZHOU PRACTICAL MEDICINE

摘　　要：目的比较硬膜外丁丙诺啡-氟哌利多超前镇痛对胆囊切除术术中镇痛效果和术后镇痛的影响及其安全性。方法选择ASAⅠ～Ⅱ级，60岁以下成年人，择期在硬膜外麻醉下行胆囊切除术的患者30例，随机分为超前镇痛组（Ⅰ组）与术后镇痛组（Ⅱ组），每组15例，工组在局麻药起效前15min经硬膜外导管一次性注射丁丙诺啡0．06mg（效能与2mg吗啡相当和氟哌利多1mg；Ⅱ组在术毕即硬膜外注入上述等量药物，术后48h两组均行患者自控硬膜外镇痛（PCEA）治疗。记录术中局麻药用量，术中、术后镇痛效果及不良反应。结果术中局麻药用量Ⅰ组明显少于Ⅱ组（P〈0．01），术中镇痛效果工组明显优于Ⅱ组，术后综合镇痛质量工组优于Ⅱ组。结论丁丙诺啡一氟哌利多硬膜外超前镇痛安全有效，且效果优于术后镇痛。Objective To compare the efficacy and safety of epiduml buprenorphine - droperidol preemptive analgesia of the patients undergoing eholeeystectomy with postoperative analgesia. Methods 30 adults in ASA physical status Ⅰ -Ⅱunder the age of 60 years undergoing elective eholeeystectomy were randomly divided into two groups：preemptive analgesia group （group Ⅰ , n = 15） and postoperative analgesia group（group Ⅱ , n = 15） .Ⅰn group Ⅰ , single bolus of buprenorphine 0.06 mg and droperidol 1 mg fixed in normal saline was injected epidttrally 15 min before local anesthetic ad ministration. Ⅰn group Ⅱ , the same dose of drugs as in group Ⅰ was given immediately at the end of surgery and then the patients in two groups were followed 5y PCEA postoperatively for 48 h. Register the consumption of local anesthetics during the operation, the analgesia efficiency and ad- verse reaction during and after the operation. Results in group Ⅰ , the consumption of local anesthetics during the operation was signifieandy lower than that in group Ⅱ, and the analgesia efficiency was significantly superior to that in group Ⅱ（ P 〈 0.01 ）. In group Ⅱ , the comprehensive analgesia quality was superior to that in group Ⅱ after the operation. Conclusion Preemptive anal- gesia with epiduml buprenorphine- droperidol was efficient without any significant adverse reaction and superior to postoperative pain- relief.

关 键 词：硬膜外 超前镇痛 丁丙诺啡 氟哌利多 

分 类 号：R713[医药卫生—妇产科学] R657.4[医药卫生—临床医学]