不同剂量芬太尼混合甲磺酸罗哌卡因对下腹部手术病人硬膜外麻醉效果的影响  

Epidural anesthesia with different dosage of fentanyl combined with ropivacaine mesylate for abdominal surgery

作　　者：崔华庆[1] 贾树山[2] 

机构地区：[1]胜利石油管理局胜利医院麻醉科,东营257055 [2]滨州医学院附属医院麻醉科

出　　处：《滨州医学院学报》2012年第6期431-433,共3页Journal of Binzhou Medical University

摘　　要：目的比较不同剂量芬太尼混合甲磺酸罗哌卡因对下腹部手术病人硬膜外麻醉效果的影响。方法择期行下腹部手术病人120例,ASAⅠ级,年龄20～53岁,随机分为4组:甲磺酸罗哌卡因组(R组)、芬太尼10、20、30μg分别混和甲磺酸罗哌卡因(Fl、F2、F3)组,每组30例。R组硬膜外注人0.75%甲磺酸罗哌卡因15 ml,Fl、F2、F3组0.75%甲磺酸罗哌卡因15 ml分别混合芬太尼10、20、30μg硬膜外注入。记录感觉阻滞的起效时间、持续时间、最高平面及达最高平面的时间、运动阻滞的起效时间及持续时间;评价腹部运动阻滞、麻醉效果及不良反应。结果与R组比较,F1、F2、F3组感觉阻滞的起效时间及达最高平面的时间缩短,持续时间延长,最高平面升高,腹肌运动阻滞和麻醉效果改善(P<0.05);以F2,F3组麻醉的效果较好,但与其他各组相比,F3组寒战、恶心呕吐的发生率增高(P<0.05);各组间下肢运动阻滞的起效时间、持续时间及Bromage评分比较差异无统计学意义(P>0.05)。结论混合20、30μg芬太尼均可增强0.75%甲磺酸罗哌卡因对下腹部手术病人的硬膜外麻醉效果,但以混合20μg芬太尼为最适宜。Objective The aim of this study was to evaluate the effectiveness of different dosage of fentanyl combined with ropivacaine mesylate for abdominal surgery. Methods 120 patients undergone abdominal surgery under epidural anesthesia were randomized into four groups ： group of ropivacaine （ group R ） , group of fentanyl with the dosage of 10,20,30μg （ group F1, F2, F3 ）. Up-effect time and sustained time of feeling and motion block, block effect of four groups of patients were observed. Results The up-effect time of group F1, F2,F3 was shorter than group R, and the sustained time of group F1, F2,F3 was longer than group R （P〈0. 05） ; The block effect of group F2,F3 was better than group R and group F1. The incidence of nausea and vomiting in group F3 was significantly higher than that in another three groups. Conclusion The results suggest that 20,30μg of fentanyl combined with ropivacaine mesylate improves the quality of epidural anesthesia for abdominal surgery hut that adding 20μg of fentanyl Is most appropriate.

关 键 词：罗哌卡因 芬太尼 硬膜外麻醉 下腹部手术 

分 类 号：R614[医药卫生—麻醉学]