罗哌卡因分别复合布托啡诺、芬太尼或吗啡用于剖宫产术后硬膜外自控镇痛的比较  

Efficacy Comparison of Ropivacaine Combined with Butorphanol,Fentanyl or Morphine on Patient-controlled Epidural Analgesia

作　　者：王燕[1] 熊良志[1] 肖峰[1] 周龙[1] 王宇[1] 

机构地区：[1]郧阳医学院附属太和医院麻醉科,湖北十堰442000

出　　处：《郧阳医学院学报》2009年第1期26-28,共3页Journal of Yunyang Medical College

摘　　要：目的:研究罗哌卡因分别复合布托啡诺、芬太尼或吗啡用于术后硬膜外自控镇痛(PCEA)的效应和副作用。方法:120例择期硬膜外麻醉下行剖宫产手术患者,随机分为布托啡诺组(罗哌卡因+布托啡诺),芬太尼组(罗哌卡因+芬太尼)和吗啡组(罗哌卡因+吗啡),采用LCP模式行PCEA,记录三组患者镇痛药用量、PCA总次数和有效次数、视觉模拟评分(VAS)、下肢运动阻滞评分。结果:与芬太尼、吗啡组相比,布托啡诺组镇痛药用量、PCA总次数和有效次数均降低(P<0.05),术后4、8和12 h VAS评分下降(P<0.05),而芬太尼组和吗啡组间无差异(P>0.05)。三组间运动阻滞评分亦无统计学差异(P>0.05)。布托啡诺组瘙痒、恶心呕吐、呼吸抑制的发生率低于芬太尼和吗啡组(P<0.05或P<0.01)。结论:罗哌卡因复合布托啡诺用于PCEA效果良好,副作用少,具良好临床使用价值。Objective To investigate the efficacy and side effects of ropivacaine combined with butorphanol,fentanyl or morphine on patient-controlled epidural analgesia （PCEA）. Methods One hundred and twenty patients undergoing cesarean section under epidural anesthesia were randomly divided into three groups ： group B （ butorphanol ＋ ropivacaine ） , group F （ fentanyl ＋ ropivacaine） and group M （ morphine ＋ ropivacaine）. PCEA was performed by LCP model,the the intaking dosage, the times of PCA and effective times, visual analogue pain scales （VAS） and modified Bromage score were recorded. Rusults The intaking dosage,the times of PCA and effective times in group B was significantly decreased than that in group F and group M （P 〈0.05 ） ,the VAS at 4h,8h and 12h were all decreased（ P 〈0.05 ） ,but there was no significant difference between group F and group M （ P 〉0. 05）. There was no significant difference in modified Bromage score among the three groups. The incidence of side effects including pruritus, nausea and vomiting, and respiratory depress was lower in group B than in group F and M （ P 〈 0.05 or P 〈 0.01 ）. Conclusion Ropivacaine combined with butorphanol is suitable for PCEA with their good results and less side effects.

关 键 词：罗哌卡因 布托啡诺 芬太尼 吗啡 自控镇痛 

分 类 号：R614[医药卫生—麻醉学]