0.125%罗哌卡因和0.1%左旋布比卡因复合舒芬太尼用于经尿道前列腺电切术后硬膜外镇痛的效果比较  

Comparison of 0.125% ropivacaine and 0.1%levobupivacaine combined with sufentanil for epidural analgesia after transurethral resection of the prostate

作　　者：郭善斌[1] 田悦[2] 

机构地区：[1]中国医科大学附属盛京医院药学部,沈阳110004 [2]中国医科大学附属盛京医院麻醉科,沈阳110004

出　　处：《实用药物与临床》2013年第4期301-304,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的比较0.125%罗哌卡因和0.1%左旋布比卡因复合舒芬太尼用于经尿道前列腺电切(TURP)术后硬膜外镇痛的效果和不良反应。方法选取择期行TURP术的患者56例,ASA分级Ⅰ～Ⅲ。随机分成罗哌卡因镇痛组(R组)和左旋布比卡因镇痛组(L组)。两组患者均行腰硬联合阻滞麻醉,术后连接硬膜外镇痛泵。R组配方为0.125%罗哌卡因复合舒芬太尼0.3μg/mL;L组配方为0.1%左旋布比卡因复合舒芬太尼0.3μg/mL。记录患者术前一般状况、术后各时点镇痛效果和运动阻滞评分。记录术后镇痛泵使用、患者恢复和不良反应发生情况并调查患者对镇痛的总体满意度。结果两组患者术后各时点VAS评分、改良Bromage评分比较差异无统计学意义(P>0.05),两组活动时VAS评分均高于同一时点安静时评分(P<0.05)。两组患者镇痛泵使用情况及术后静注吗啡例数比较差异无统计学意义(P>0.05)。两组患者镇痛期间不良反应发生、术后恢复和对镇痛的整体满意度比较差异无统计学意义(P>0.05)。结论 TURP术后应用0.125%罗哌卡因或0.1%左旋布比卡因复合舒芬太尼0.3μg/mL行硬膜外镇痛均能获得满意效果,无明显毒副作用。Objective To compare the anesthetic epidural effects and adverse effects of 0. 125% ropivacaine plus sufentanil versus 0. 1% levobupivacaine plus sufentanil in patients for transurethral prostatectomy. Methods 56 patinets, ASA physical status Ⅰ～Ⅲ undergoing transurethral prostatectomy were enrolled. All the patients received combined spinal-epidural anesthesia during surgery. Patients were randomly assigned to two groups in which postoperafive analgesia was performed by continuous lumbar epidural infusion of 0. 125% ropivacaine and 0. 1% levobupivacaine with sufentanil 0. 3 μg/mL. Visual analogue scale （ VAS ） , modified bromage score （ MBS ） , additional analgesic requirement, hemodynamic effects, pruritus, nausea and vomiting, postoperative recovery and patients＇ satisfaction were evaluated within 48 h. Results There was no difference in the incidence of side-effects （ P 〉 0. 05 ）. The two groups were also similar with regard to pataent charactenstacs, VAS, MBS, postoperative recovery ano patients＂ saustacuon （P 〉 0. 05 ）. However, VAS when moving was always higher than that when resting within each group （ P 〈 0. 05 ）. Conclusion Epidural 0. 125% ropivacaine and 0. 1% levobupivacaine combined with sufentanil 0. 3 μg/mL provided comparable postoperative analgesia and an equal incidence of adverse effects.

关 键 词：罗哌卡因 左旋布比卡因 硬膜外镇痛 

分 类 号：R614[医药卫生—麻醉学]