经尿道前列腺电切术后硬膜外舒芬太尼复合左布比卡因镇痛解痉效果观察  

Postoperation analgesia effects and treating cystospasm with continuous epidural sufentanil levobupivacaine after transurethral resection of prostate

作　　者：钟焕晖[1] 侯立力[1] 罗红菱[1] 周青春[2] 

机构地区：[1]南华大学附属南华医院麻醉科,湖南衡阳421002 [2]南华大学附属南华医院泌尿外科,湖南衡阳421002

出　　处：《吉林医学》2011年第22期4559-4561,共3页Jilin Medical Journal

摘　　要：目的:观察硬膜外舒芬太尼复合左布比卡因用于前列腺电切术后的临床镇痛解痉效果。方法:选择ASAⅠ-Ⅲ级,在连续硬膜外阻滞或复合腰麻下行经尿道前列腺电切术的患者156例,随机分为两组:舒芬太尼复合左布比卡因(SB)组为术后硬膜外予0.015μg/(ml.kg)舒芬太尼加0.2%左布比卡因患者自控镇痛(PCEA);芬太尼(F)组为术后静脉给予0.2μg/(ml.kg)芬太尼患者自控镇痛(PCIA)。镇痛泵总容量均为100 ml,背景剂量2 ml/h,自控给药量SB组3 ml/次、F组0.5 ml/次,锁定间隔时间15 min。观察并记录术后48 h镇痛评分、额外静脉滴注间苯三酚病例数、膀胱痉挛发作次数、膀胱痉挛持续时间、膀胱冲洗时间、冲洗液转清时间、不良反应等发生率及住院时间。结果:两组在术后48 h的静息、咳嗽和活动时的VAS评分均<3分,镇痛效果均满意,P>0.05表示差异无统计学意义。F组有3例在镇痛期间因疼痛痉挛额外静脉滴注间苯三酚40 mg,SB组无一人追加其他镇痛解痉药,两组比较,差异有统计学意义(P<0.05)。而SB组的膀胱痉挛发作次数、膀胱痉挛持续时间、膀胱冲洗时间、冲洗液转清时间、不良反应及住院时间均明显小于对照组F组,差异有统计学意义(P<0.05)。结论:0.015μg/(ml.kg)舒芬太尼复合0.2%左布比卡因可安全、有效地用于前列腺汽化电切术后镇痛,镇痛解痉的效果明显优于0.2μg/(ml.kg)芬太尼静脉组,不良反应少。Objective To study the efficacy and the safety of continuous epidural sufentanil levobupiv acaine after transurethral resection of prostate.Method Total 156 patients ASA I ～ III class of transureth ral resection of prostate were randomly allocated to SB group（n=75） and con trol F group（n=81）.SB group of 0.015 μg/（ml·kg） sufentanil and 0.2% le v obu pivacaine by patient-controlled epidural analgesia（PCEA） after transurethral re section of prostate.F group of 0.2 μg/（ml·kg） fentanil by patient-controlled in travenous analgesia（PCIA） after transurethral resection of prostate.Pump′s vo l u me was 100 ml,background infusion 2 ml/h,SB group blous 3 ml and F group 0.5 m l,lockout time 15 min.Visual analog scale（VAS） in 48 h after surgery,quanti t y of dripping phloroglucinol and cystospasm incidence,the duration of cystospas m,the time of bladder douche and incidence rate of adverse reaction and so on w ere observed and recorded.Results The VAS of the two groups were both less than 3,there was no significan t difference in efficacy between SB and F group（P0.05）.Other data of SB gr oup was superior to F group（P0.05）.Conclusion It is safe and effective to treat cystospasm that 0.0 1 5 μg/（ml·kg） sufentanil and 0.2% levobupivacaine are used by PCEA after trans urethral resection of prostate.There are few adverse reactions.

关 键 词：舒芬太尼 左布比卡因 TURP 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]