摘要
目的:对不同浓度罗比卡因用于骶管麻醉肛肠手术患者术后镇痛效果的比较,并探讨其最低有效浓度的最佳镇痛效应。方法:选择2000-03/2004-06在右江民族医学院附属医院麻醉科拟行骶管麻醉肛肠手术患者120例。随机分为0.5,0.75,1和1.25g/L罗比卡因组,每组30例。术毕接硬膜外自控镇痛泵,分别给于相应浓度罗比卡因+舒芬太尼1mg/L,二者比例(mL)为1∶1。硬膜外自控给药0.5mL/次,锁定时间为15min。观察镇痛后4,8,16,24,48,72h疼痛和镇痛后24,48,72h下肢运动神经阻滞情况(取平均值)。疼痛采用目测类比评分法(VAS)评定(0分为无痛,10分为最痛),下肢运动神经阻滞采用Bromage评分法评定(0分为无阻滞,4分为阻滞)。结果:按意向处理分析,120例患者均进入结果分析。①疼痛目测类比评分:术后8,16,24h0.5g/L罗比卡因组高于其他3组(P<0.05),0.75,1和1.25g/L罗比卡因组间比较无显著性差异(P>0.05);术后48,72h时0.5和0.75g/L罗比卡因组分值高于1和1.25g/L罗比卡因组(P<0.05),1和1.25g/L罗比卡因组间比较无明显差别。②下肢运动神经阻Bromage评分:1.25g/L罗比卡因组为0.9±0.8,明显高于其他3组(P<0.05),0.5,0.75和1g/L罗比卡因组间比较无明显差异(0.5±0.5,0.6±0.4,0.7±0.6,P>0.05)。结论:1g/L罗比卡因加1mg/L舒芬太尼用于骶管麻醉肛肠手术患者术后镇痛是较为适宜的浓度,并可产生较为满意的镇痛效果。
AIM:To compare the analgesic effect of ropivacaine of different concentration after anorectal operation on sacral canal in order to investigate the best analgesic effect of the lowest effective concentration. METHODS:From March 2000 to June 2004,120 patients scheduled to perform anesthesia in sacral canal were selected from Department of Anesthesiology,Affiliated Hospital of Youjiang Medical College of Nationalities.They were equally and randomly divided into four groups:0.5 g/L,0.75 g/L,1 g/L and 1.25 g/L ropivacaine groups.Epidural patient-controlled analgesia(EPCA) pump was used in each group immediately after operation,followed by ropivacaine of corresponding concentration plus 1 mg/L fentanyl at the ratio of 1∶1.All patients received EPCA 0.5 mL once for a total of 15 minutes.Pain at 4,8,16,24,48 and 72 hours after analgesia,and motor nerve blocking of lower limbs(average value) at 24,48 and 72 hours after analgesia were observed respectively.Pain was assessed by visual analogue scale (VAS)(0 as painlessness and 10 points as the most severe pain),and motor nerve blocking of lower limbs by Bromage scoring(0 as no blocking and 10 points as blocking). RESULTS:According to the intention-to-treat,all the 120 patients were involved in the result analysis.①The VAS score at 8,16 and 24 hours after operation in the 0.5 g/L ropivacaine group was significantly higher than that in the other groups(P< 0.05),and it was insignificantly different in the inter-group comparison of 0.75,1 and 1.25 g/L groups(P >0.05).The VAS score at 48 and 72 hours after operation was significantly higher in the 0.5 g/L and 0.75 g/L groups than in the 1 g/L and 1.25 g/L groups(P< 0.05),and it had insignificant difference between the latter two groups.②The Bromage score in the 1.25 g/L group was 0.9±0.8,significantly higher than that in the other three groups(P< 0.05),but it was insignificantly different among the 0.5 g/L,0.75 g/L and 1 g/L groups(0.5 ±0.5,0.6±0.4,0.7±0.6 respectively,P >0.05). CONCLUSION:Ropivaeane 1 g/L plus fentan
出处
《中国临床康复》
CSCD
北大核心
2005年第22期26-27,共2页
Chinese Journal of Clinical Rehabilitation
