摘要
目的比较不同浓度罗哌卡因与芬太尼复合用于开胸术后硬膜外自控镇痛的临床效果。方法将60例ASAⅠ～Ⅱ级择期行肺切除手术病人随机分为三组,每组20例,术毕分别施行不同配方胸段硬膜外镇痛:0.2%罗哌卡因(Ⅰ组);0.15%罗哌卡因/芬太尼4μg/ml(Ⅱ组);0.1%罗哌卡因/芬太尼4μg/ml(Ⅲ组)。观察术后HR、BP变化,VAS评分,总按压次数与实际进药次数之比(D/D),恶心、呕吐、搔痒和尿潴留的发生率,动脉血PaCO2。结果VAS评分Ⅰ组>Ⅱ、Ⅲ组(p<0.01),Ⅱ、Ⅲ组间无显著性差异(p>0.05);按压总数和实进数Ⅰ组>Ⅲ组>Ⅱ组(p<0.01),D/D比值在0～2之间以Ⅱ组最多(p<0.05)。结论0.15%罗哌卡因/芬太尼4μg/ml配方用于开胸术后硬膜外病人自控镇痛(PCEA)可达到满意的临床效果,且副作用较少。
Objective To compare the efficiency of patient - controlled epidural analgesia with ropivacaine and fentanyl mixture for postthoracotomy pain. Methods Sixty patients undergoing selective lung surgery were randomized in a double - blinded manner to receive one of three solutions for patient - controlled thoracic epidural anal- gesia. 0.2% ropivacaine （ group Ⅰ , n = 20）, 0.15 % ropivacaine/fentanyl 4 μg/mL （ group Ⅱ , n = 20）, or 0.1% ropivacaine/fentanyl 4 μg/mL （group, n = 20） was started when operation ended. We assessed heart rate, blood pressure, visual analogue scores （VAS）, demand/delivery （D/D） ratio, PaC02, respiratory rate, and side effects （ nausea, vomiting, and pruritus） for 48 h. Results VAS pain scores in group I was greater than that in group Ⅱ and group Ⅲ （p 〈 0.01 ）, which was no significant difference between the latter two groups （p 〉 0. 05 ）. there were more patients whose D/D ratio was within 0 and 2 than the other groups （p 〈 0.05 ）. Conclusion 0.15 % ropiva- caine/fentanyl 4 μg/ml can provide adequate pain relief for patient - controlled epidural analgesia after posterolateral thoracotomy, with fewer side effects.
出处
《现代医院》
2008年第1期18-19,共2页
Modern Hospitals
关键词
酰胺类
芬太尼
镇痛
开胸术
Amides, Fentanyl, Analgesia, Thoracotomy
