吗啡联合罗哌卡因硬膜外自控镇痛在晚期癌痛治疗中的应用  

Morphine combined with ropivacaine for patient-controlled epidural analgesia advanced cancer patient with pain

作　　者：杨小磊[1] 钱晓敏[1] 管忍[1] 王爱军[1] 高榴益[1] 

机构地区：[1]苏州大学附属常熟医院（常熟市第一人民医院）麻醉科,215500

出　　处：《实用疼痛学杂志》2010年第5期335-337,共3页Pain Clinic Journal

基　　金：常熟市卫生局科研项目

摘　　要：目的评价吗啡联合罗哌卡因硬膜外自控镇痛（PCEA）对晚期癌痛的临床疗效。方法晚期癌痛患者39例，采用PCEA方法用于镇痛，配方为0．075％～0．125％罗哌卡因100ml，加吗啡10～30mg、氟哌利多5mg、地塞米松10mg，锁定每次注液量及间隔时间。记录并统计治疗后的VAS、镇静评分（Ramsay）、生活质量评分（QOL）及不良反应发生率。结果癌痛完全缓解33例（84．6％），部分缓解6例（15．4％），缓解率为（100．0％）。治疗前后疼痛程度差异有统计学意义（P〈0．01），患者治疗后生活质量较治疗前明显改善（P〈0．05），不良反应明显少。结论PCEA治疗晚期顽固性癌痛疗效确切，方便、安全，且能增强镇静和抗焦虑作用，改善癌症患者的生活质量。Objective To observe the effects of morphine combined with ropivacaine by patient controlled epidural analgesia （PCEA） in advanced cancer patients with pain. Methods Thirty-nine advanced cancer patients with pain were treated with PCEA. Morphine 10-20 mg, droperidol 5- 10 mg and dexamethasone 10 mg were added into 0. 075 %-0. 125% ropivacaine 100 ml , the dose and interval injected were strictly controlled. The VAS, Ramsay, QOL and incidence of side effects during the treatment were recorded. Results The pain levels were relieved completely in 33 patients （84.6%）, and partially relieved in 6 patients （15.4%）. After the treatment, the severity of pain were significant decreased （P〈0.01）, the quality of life （QOL） were improved （P〈0. 05）, and the side effects were reduced markedly. Conclusion Morphine combined with ropivacaine in PCEA is a reliable, convenient and safe method for treatment of refractory cancer pain, with better pain controll, quality of life improved and side-effects less.

关 键 词：镇痛 硬膜外 镇痛 患者控制 肿瘤 疼痛 罗哌卡因 吗啡 

分 类 号：R614.42[医药卫生—麻醉学]