不同浓度罗哌卡因用于下腹部手术后自控硬膜镇痛的临床观察  

Clinical observation of different concentrations of ropivacaine for PCEA after lower abdominal surgery

作　　者：郑自富 项燚 梅诗全 沈培[1] 崔玲[1] 

机构地区：[1]霍山县医院麻醉科,安徽霍山237200

出　　处：《现代医药卫生》2010年第18期2751-2753,共3页Journal of Modern Medicine & Health

摘　　要：目的:观察不同浓度的罗哌卡因用于术后患者硬膜外自控镇痛(PCEA)的临床效果。方法:选择下腹部手术患者120例,随机分成R1组、R2组和R3组,每组40例。术后给予PCEA,R1组镇痛药为罗哌卡因200mg+枸橼酸芬太尼0.3～0.5mg+氟哌利多2.5mg,用生理盐水稀释至200mL;R2组镇痛药为罗哌卡因250mg+枸橼酸芬太尼0.3～0.5mg+氟哌利多2.5mg,用生理盐水稀释至200mL;R3组镇痛药为罗哌卡因300mg+枸橼酸芬太尼0.3～0.5mg+氟哌利多2.5mg,用生理盐水稀释至200mL。分别于术后6、12、24、48h随访并记录:(1)镇痛效果,采用VAS评估;(2)采用Bromage评分进行下肢运动阻滞程度评分;(3)观察不良反应。结果:镇痛效果比较,R1组VAS评分高于R2组和R3组,但3组组间比较差异无统计学意义(P>0.05)。3组双下肢运动阻滞程度比较,R1组与R2组无统计学差异,R3组与R1组和R2组比较差异有统计学意义(P<0.05)。3组不良反应观察比较差异无统计学意义(P>0.05)。结论:0.125%罗哌卡因更适宜下腹部手术术后PCEA。Objective：To observe the clinical effect of different concentrations of ropivacaine for postoperative patient-controlled epidural analgesia.Methods：120 patients with lower abdominal surgery were randomly divided into R1 group,R2 group and R3 group,40 cases in each group.Postoperative epidural analgesia was given,R1 group of analgesics for ropivacaine 200 mg＋fentanyl citrate 0.3～0.5 mg＋droperidol 2.5 mg, with normal saline diluted to 200 ml;R2 group of analgesic drugs ropivacaine 250 mg ＋ fentanyl citrate 0.3～0.5 mg＋droperidol 2.5 mg, with normal saline diluted to 200 ml;R3 group of analgesic drugs ropivacaine fentanyl citrate 300 mg＋0.3～0.5 mg＋droperidol 2.5 mg,with normal saline diluted to 200 ml.To follow up at 6,12,24,48 h respectively after operation and record：（1） the analgesic effect, using VAS assessment;（2） using Bromage score for lower extremity motor block severity score;（3） observation of side effects.Results：Comparing the results of analgesic effect,the VAS score in R1 group and R2 group was higher than that in the R3 group,but the three groups had no significant difference （P0.05）.Comparing limb motor block level,R1 and R2 groups had no statistically sig-nificant difference.Comparing R3 group with R1 group and R2 group there was significant difference （P〉0.05）.Three groups showed no statistical difference in side effects （P〉0.05）.Conclusion：0.125% ropivacaine is more suitable for postoperative epidural analgesia in lower abdominal surgery.

关 键 词：手术后 硬膜外 镇痛 罗哌卡因 

分 类 号：R614[医药卫生—麻醉学]