摘要
目的探讨高乌甲素用于胃癌术后病人硬膜外自控镇痛(PCEA)临床效果及不良反应.方法 30例ASAⅠ～Ⅱ行骨癌根治术的病人,随机分为高乌甲素组(RL)、芬太尼组(RF)、对照组(C),每组10例,术毕RL组以0.02%高乌甲素复合0.1%罗哌卡因,RF组以0.0003%芬太尼复合0.1%罗哌卡因行术后自控镇痛.RL和RF组以2ml/h硬膜外腔持续注入,疼痛时由病人补充镇痛剂量每次0.5ml,锁定间隔时间15min.C组当疼痛剧烈时,肌注曲马多.于术后4h、8h、24h、48h观察三组镇痛效果.结果 VAS评分比较差别无显著性(P＞0.05);C组VAS评分显著高于RL组与RF组比较差别有显著性(P＜0.05).MAP、HR、SpO2、RR于麻醉前、术后各时点RL与RF两组比较差别无显著性(P＞0.05);C组与RL、RF两组术后各时点比较有显著性差异(P＜0.05).恶心发生率RL组低于RF组和C组;呕吐、皮肤瘙痒、尿潴留发生率三组比较差别无显著性(P＞0.05).结论 RL组镇痛效果优于RF组.
Objective To investigate the clinical effect and adverse reaction of lappaconitine with ropivacaine for patient-controlled epidural analgesia (PCEA) after stomach cancer operation.Methods 30 cases with ASA Ⅰ~Ⅱ conducted stomach cancer operation were randomly divided into lappaconitine group (RL) ;fentanyl group (RF) and controlled analgesia (C).After operation, Group RL received 0.02% lappaconitine with 0.1% ropivacaine and Group RF 0.0003% fentanyl with 0.1% ropivacaine for postoperative analgesia; when necessary , bolus dosage was 0.5 ml with 15 min lock out time and 2 ml/h background infusion for the patients of group RL and RF. Group C when paining ,the patients was injected tramadol. The analgesic effect ,the adverse reaction, were observed in three groups at postoperation 4, 8, 24, 48 h. Results The VAS values were not significantly different at each time points after operation (P> 0.05 );in group C , the VAS values at each time points were higher than that in group RL and RF (P<0.05 ). MAP, HR, SpO_2 and RR of group RL and RF were not significantly different at preinduction of anesthesia and each time points after operation (P >0.05 );but in group C at each time points were higher than that in Group RL and RF (P<0.05 ). The incidence of nausea was lower in group RL than that in group RF and C ; The incidence of vomiting , pruritus and urine retention was no significant difference among the three groups (P>0.05).Conclusion The analgesia affect of RL group is superior to that of RF group in postoperative patient epidural analgesia.
出处
《医药论坛杂志》
2005年第2期13-14,16,共3页
Journal of Medical Forum
关键词
硬膜外自控镇痛
胃癌
高乌甲素
罗哌卡因
Patient controlled epidural analgesia
Cancer of stomach
Lappaconitine
Ropivacaine
