左旋布比卡因和罗哌卡因分别复合舒芬太尼应用于食道癌术后硬膜外自控镇痛的比较  

Comparison between levobupivacaine or ropivacaine combined with sufentanil for postoperative patient-controlled epidural analgesia(PCEA) in esophagus carcinoma

作　　者：胡伟[1] 李金玉[1] 

机构地区：[1]南京医科大学附属淮安第一人民医院麻醉科,江苏淮安223300

出　　处：《海南医学》2012年第18期33-35,共3页Hainan Medical Journal

摘　　要：目的比较左旋布比卡因和罗哌卡因分别复合舒芬太尼应用于食道癌开胸术后硬膜外自控镇痛(PCEA)的临床效果。方法硬膜外麻醉复合全身麻醉行食道癌开胸术、美国麻醉医师学会(Americansociety of anesthesiologists,ASA)分级Ⅰ～Ⅱ级的60例患者,随机分为左旋布比卡因复合舒芬太尼(LF)组和罗哌卡因复合舒芬太尼(RF)组,每组30例。手术结束前10min经硬膜外腔注入负荷剂量,记录启用镇痛泵后1h、4h、8h、24h、48h的视觉模拟评分法(VAS)评分、改良Bromage分级、按压次数、24h药量并记录术后不良反应。结果各时段的VAS评分两组间差异无统计学意义(P>0.05);改良Bromage分级RF组低于LF组(P<0.05),两组副反应发生率比较RF组略高,差异有统计学意义(P<0.05)。结论左旋布比卡因和罗哌卡因分别复合舒芬太尼用于术后硬膜外自控镇痛均可取得满意的镇痛效果。罗哌卡因组对运动神经的阻滞较轻于左旋布比卡因组,术后恶心呕吐略高于左旋布比卡因组。Objective To compare the clinical effect oflevobupivacaine or ropivacaine combined with sufentanil for postoperative patient-controlled epidural analgesia （PCEA） in esophagus carcinoma. Methods Sixty pa- tients of ASA grade Ⅰ～Ⅱ after esophagus carcinoma thoraeotomy were divided randomly into levobupivacaine＋sufen- tanil （LF） group and ropivacaine＋sufentanyl （RF）. group, each with 30 cases. 10 min before the end of the operation, the two groups were given the loading does, respectively. The VAS scores and modified Bromage degrees 1 h, 8 h, 24 h and 48 h after operation, the press times, 24 h dose and side effects were recorded. Results There were no statistically significant difference between the two groups in VAS scores （P〉0.05）, but there were statistically significant difference in modified Bromage degrees （P〈0.05）. The incidence of side effects in ~ group were significantly higher than that in LF group （P〈0.05）. Conclusion Levobupivacaine or ropivacaine combined with fentanyl could be safely and effec- tively used for postoperative analgesia. Ropivacaine has slighter paralytic effects but with more nausea and vomiting.

关 键 词：左旋布比卡因 罗哌卡因 舒芬太尼 硬膜外自控镇痛 

分 类 号：R730.56[医药卫生—肿瘤]