罗哌卡因联合吗啡或芬太尼镇痛对手术后肠蠕动的影响  

Observation of ropivacaine combined morphine or fentangl for controlled epidural analgesic on intestinal peristalsis

作　　者：谢亚红[1] 

机构地区：[1]重庆市第九人民医院麻醉科,重庆市400700

出　　处：《中国基层医药》2012年第3期341-342,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨罗哌卡因联合不同镇痛药物对手术后肠蠕动恢复情况的影响。方法对105例普外科择期手术患者，ASAⅠ-Ⅱ级，根据不同的镇痛方案分成三组，吗啡组：0．125％罗哌卡因＋0．005％吗啡＋0．005％氟哌利多，芬太尼组：0．125％罗哌卡因＋0．0005％芬太尼＋0．005％氟哌利多，对照组不实施患者术后自控镇痛；镇痛治疗后4、8、12、24、36h进行随访，观察疼痛程度、镇静状态、平均动脉压（MAP）、心率（HR）、呼吸频率（RR）、脉搏氧饱和度（SpO2），并记录肠蠕动恢复时间。结果吗啡组与芬太尼组均取得较好的镇痛效果，VAS评分显著低于对照组（P〈0．01）；芬太尼组肠蠕动恢复时间为（52．65±10．63）h，较吗啡组、对照组[分别为（73．11±14．23）、（74．54±16．61）h]均明显缩短（均P〈0．05）。结论罗哌卡因联合吗啡、芬太尼行患者术后自控镇痛均能获得良好的效果；罗哌卡因与芬太尼联用可缩短肠蠕动的恢复时间。Objective To investigate the effects of patient controlled epidural analgesic（PCEA） used ropivacaine and different analgesic drugs on recovery of postoperative intestinal peristalsis. Methods 105 patients of abdominal surgery undergoing selection operating, ASA Ⅰ-Ⅱ grade. Every section was randomly divided into three groups according to the content of drugs. Morphine group：0. 125% ropivacaine ＋ 0. 005 % morphine ＋ 0. 005% droperidol. Fentanyl group ：0. 125% ropivacaine ＋ 0. 0005% fentanyl ＋ O. 005% droperidol. Control group is not used PCEA. All patients were taken PCEA for 36 hours. The pain scores of visual analog scale （VAS）, sedative scores of Ramsay scale, respiratory and hemodynamic paremeters, and side effects were recorded at 4,8,12,24,36 hours postoperatively. The time of the recovery of intestinal peristalsis was also recorded. Results Good analgesic effect could be found in morphine group and fentanyl group, the VAS grades were significantly lower in morphine group and fentanyl group than that in control group（P 〈 0.01 ）. The time of the recovery of intestinal peristalsis was shorter in fentanyl group than that in morphine group and control group respectively （P 〈 0.05 ）. Conclusion Compound solution with low concentration of ropivacaine and morphine or fentanyl can be used for postoperative analgesia, and ropivacaine combined with fentanyl can shorten the time of the recovery of intestinal peristalsis.

关 键 词：胃肠活动 吗啡 芬太尼 罗哌卡因 

分 类 号：R614[医药卫生—麻醉学]