不同浓度氯普鲁卡因复合吗啡应用于直肠癌术后硬膜外镇痛效果的临床观察  

Clinical Observation on the Analgesia Efficacy of Chloroprocaine Combined with Morphine Extradurally Used at Different Concentration Following Operation for Rectal Carcinoma

作　　者：张乙[1] 姜万维[1] 隋成[1] 王庆辉[1] 戚军[1] 

机构地区：[1]大连大学附属新华医院麻醉科,辽宁大连116021

出　　处：《中国肛肠病杂志》2009年第10期19-20,共2页Chinese Journal of Coloproctology

摘　　要：为观察氯普鲁卡因复合吗啡应用于直肠癌术后硬膜外镇痛的临床效果，我们选择120例直肠癌患者，其中行直肠癌根治术（经腹会阴联合直肠癌切除术）52例，直肠癌切除术68例，随机分成A、B、C三组，各40例。A组中，直肠癌根治术16例，直肠癌切除术24例；B组中，直肠癌根治术17例，直肠癌切除术23例；C组中，直肠癌根治术19例，直肠癌切除术21例。术后给予硬膜外持续镇痛。A组用1．0％氯普鲁卡因＋0．1mg／ml吗啡，B组用1．2％氯普鲁卡因＋0．1mg／ml吗啡，C组用1．5％氯普鲁卡因＋0．1mg／ml吗啡。结果显示，A组镇痛效果较差，VAS为28．0±4．7～57．0±6．2，有13例诉求3％氯普鲁卡因5ml或哌替啶100mg肌肉注射；B组镇痛效果较好，VAS为9．5±2．3～13．0±4．4；C组镇痛效果好，VAS为8．7±3．3～11．0±3．5。B，C组均无额外诉求，但B组与C组VAs评分差异无统计学意义，P〉0．05。结果表明，氯普鲁卡因复合吗啡应用于直肠癌术后硬膜外镇痛效果良好，其中以1．2％和1．5％浓度为好。The objective of this study was to investigate the analgesic efficacy of Chloroprocaine combined with Morphine for epidural block after operation of rectal cancer. The 120 patinets with rectal cancer were selected,among whom 52 cases were subjected to the radical operation（transabdomen-perineum combined resection of rectal cancer）,68 to resection of rectal cancer;they were randomly divided into three groups. A,B,C group（40 cases, each group）. In A group 16 were subjected to the former procedure, 24 to latter procedure;in B group,C group 17,19 to former,23,21 to latter were administered continuous epidural anesthesia with 1.0% Chloroprocaine＋0. 1mg/ml Morphine（A group） or 1.2o//oo Chloroprocaine＋0. lmg/ml Morphine（13 group）,or 1.5% Chloroprocaine＋0. lmg/ml Morphine（C group）. As results,in A group the VAS ranged from 28.0±4.7 to 57.0±6.2,13 cases asked for an additional of 3% Chloroprocaine 5ml or Pethidine 100mg intermuscularly;in ]3 group the VAS was even lower and ranged from 9.5±2.3 to 13.0± 4.4;in C group the VAS ranged from 8.7±3.3 to 11.0±3.5;the patients of B,C groups did not ask for an addition analgesia;but there was not statistical difference（ P〉0.05） in 13 and C group. Above results show that the analgesic efficacy of chloroprocaine combined with Morphine for epidural block after operation of rectal cancer,the efficacy was good,the better concentration was 1.2% or 1.5%.

关 键 词：直肠肿瘤 氯普鲁卡因 吗啡 术后镇痛 

分 类 号：R614.42[医药卫生—麻醉学] R971.2[医药卫生—外科学]