地佐辛配伍罗哌卡因硬膜外PCA用于产后阵痛  

Analgesic effect of dezocine combined with ropivacaine via epidual PCA on postpartum pains

作　　者：巩红岩[1] 秦元旭[1] 岳修勤[1] 

机构地区：[1]河南新乡医学院一附院麻醉科,卫辉453100

出　　处：《中国新药杂志》2011年第5期444-446,共3页Chinese Journal of New Drugs

摘　　要：目的:比较地佐辛与吗啡分别配伍0.25%罗哌卡因硬膜外剖宫产术后自控镇痛的效果。方法:择期剖宫产术患者60例,ASAⅠ～Ⅱ,随机分成两组(n=30):Ⅰ组用0.75%罗哌卡因20 mL+地佐辛10mg+生理盐水稀释至100 mL,Ⅱ组用0.75%罗哌卡因20 mL+吗啡6 mg+生理盐水稀释至100 mL。均采用LCP模式,负荷剂量5 mL,持续剂量2 mL.h-1,单次给药剂量2 mL,锁定时间10 min。全程镇痛48 h。所有患者常规行硬膜外腔穿刺置管,术后留置L2～3硬膜外导管,送回病房后(VAS=0)开启PCA泵。分别记录开机后4,8,16,202,4,324,8 h共7个时点(T1,T2,T3,T4,T5,T6,T7)的PCA泵的患者按压次数(D1)与实际进入次数(D2),同时进行VAS评分并记录肛门排气时间和恶心、呕吐等不良反应情况。结果:两组患者的一般情况、术中硬膜外用药剂量、辅助用药剂量、开启PCA泵距最后一次硬膜外注局麻药的时间等组间比较无显著性差异(P>0.05);T2,T3 VAS评分及D1/D2比值Ⅰ组稍高于Ⅱ组,但差异无统计学意义;Ⅱ组有7例患者出现恶心、呕吐3,例患者出现皮肤瘙痒,两组均没有患者出现呼吸抑制及心动过缓等情况。结论:地佐辛配伍罗哌卡因可以为剖宫产患者提供安全、有效的硬膜外术后镇痛。Objective：To investigate the analgesic effect of dezocine or morphine combind 0.25% ropivacaine via epidual PCA on postpartum pains.Methods：Totally 60 puerperas with cesarean section（ASA I^II） were divided into two groups（n=30 for each group）.They were treated with 0.75% ropivacaine 20 mL＋dezocine 10 mg/100 mL,or 0.75% ropivacaine 20 mL＋morphine 6 mg/100 mL.The loading dose was 5 mL,and the maintenance dose was 2 mL·h-1.The single doses were 2 mL,locking time was 10 min and the duration of PCA was 48 h.All puerperas used the epidural anesthesia.The punch sit was at L2-3.After operation（VAS=0）,PCA was started and evaluated at 4,8,16,20,24,32 and 48 h（T1,T2,T3,T4,T5,T6,T7）,and the number pushed（D1） and the number entered（D2） were recorded.VAS and adverse reactions were observed.Results：The general conditions and epidural drug doses were no significant differences in 2 groups（P0.05）.The VAS and D1/D2 at T2 and T3 in dezocine group showed a higher but not significant increase.After morphine treatment,7 puerperas had nausea and vomiting and 3 had itching.No respiratory depression and bradycardia occurred in all puerperas.Conclusion：Dezocine combined with ropivacaine can provide a safe and effective analgesic option in the treatment of t postpartum pains.

关 键 词：自控镇痛 硬膜外 地佐辛 罗哌卡因 

分 类 号：R971.2[医药卫生—药品]