罗哌卡因配伍曲马多或芬太尼术后硬膜外镇痛的临床研究  

Clinical research of epidural ropivacaine infusion combined with fentanyl or tramadol for postoperative analgesia

作　　者：吴建厂[1] 刘伟[1] 张春燕[1] 宋宝丽 李印玉 

机构地区：[1]周口市中心医院麻醉科,河南周口466000

出　　处：《医学信息（内.外科版）》2009年第9期790-791,共2页Medical Information Operations Sciences Fascicule

摘　　要：目的观察曲马多、芬太尼分别和罗哌卡因配伍对于术后硬膜外镇痛的效果,比较它们的临床安全性。方法选择剖宫产60例,随机分为三组。R组:0.2%罗哌卡因(n=20);F组:0.2%罗哌卡因+0.0004%芬太尼(n=20);T组0.2%罗哌卡因+0.5%曲马多(n=20);术后均应用一次性微量泵进行硬膜外镇痛。监测术后不同时间的VAS评分;观察恶心、呕吐等不良反应情况。结果R组VAS评分明显高于F组以及T组,有显著差异(P<0.05);F组和T组VAS评分无明显差异(P>0.05);F组恶心、呕吐发生率高于R组和T组(P<0.05)。结论曲马多与罗哌卡因配伍副作用发生率较低,是一种更为安全有效的术后硬膜外镇痛配方。Objective To observe the effect of fentanyl and tramadol in combination with ropivacaine on continuous epidural postoperative analgesia. Methods Sixty patients, undergoing uterine - incision delivery, were randomly divided into three groups （20 in each group） to receive 0.2% ropivacaine alone （Group R） ,0.2% ropivacaine plus 0. 0004% fentanyl（ Group F） ,and 0.2% ropivacaine plus 0.5% tramadol（ Group T）. The disposable micro - infusion pump was applied to continuous epidural postoperative analgesia. VAS were recorded at different time. The incidence of side - effect was assessed. Results The VAS in Group F or Group T were significantly less than that in Group R （P 〈 0.05 ） and no significant difference were noted between Group F and Group T （P 〉 0.05）. The incidence of nausea and vomiting in Group T was significantly lower than that in Group F （P 〈 0.05 ）. Conclusions Ropivacaine infusion combined with trarnadol is the better choice because of the less side - effects.

关 键 词：曲马多 芬太尼 罗哌卡因 硬膜外镇痛 

分 类 号：R971.2[医药卫生—药品]