摘要
目的:评价不同浓度罗哌卡因配伍咪达唑仑、芬太尼用于剖宫产术后硬膜外镇痛的临床效果。方法:选择择期子宫下段剖宫产手术患者120例,ASAI-Ⅱ级,随机分为A、B、C三组,所有患者手术均采用L1-2连续硬膜外麻醉。关腹前,经硬膜外导管注人负荷量,再用2ml/h微量止痛泵持续硬膜外输人镇痛药。各组的镇痛药均为盐酸罗哌卡配伍咪达唑仑5mg芬太尼0.2mg加生理盐水至100ml,其中A组罗哌卡因为250mg,B组罗哌卡因为200mg,C组罗哌卡因为150mg。记录术后患者6h、12h、24h和36h时间位点的镇痛、镇静、运动阻滞评分及心率、血压和不良反应。结果:三组病人镇痛(VAS评分)、镇静(Ramesay评分)和运动阻滞(MBS评分)无统计学差异(P>0.05)。在镇痛期间三组病人均安静合作。镇痛期间三组病人心率、血压组间比较无统计学差异(P>0.05)。镇痛期间A组有三例下肢麻木发生,其他不良反应比较无统计学差异。结论:C组0.15%罗哌卡因配伍咪达唑仑5mg、芬太尼0.2mg行剖宫产术后持续硬膜外镇痛,效果确切,用药量少,对患者生理影响小,副作用少,安全性高。
Objective：In order to find a high efficiency,low side effects, the clinic effect of different concentrations recipe of ropivaeaine conthined with fentanyl and midazolam for epidural analgesia were evaluated in Caesarean section. Methods ：120 patients （ASAI - II grade）were randomly grouped into A, B and C group. All of the pateins were treated with L1 -2 continual epidural analgesia. Before suture, patients were inject the analgesics through the pipe, then patients were pumped contin- uously into epidural space at the rate of 2ml/h over 48h after surgery. The analgesics used by groups were consist of different ropivaeaine combine with 5mg midazolam and 0.2mg fentanyl in physiological saline lOOml（ final volume）. The A group analgesics recipe contain 250 mg ropivacaine, B group contain 200mg ropivaeaine, and C group contain 150 mg ropivaeaine. After operation, VAS, Ramesay score, MBS, HR, BP, Bromage score and side effects were respectively recorded at 6,12,24 and 36h. Results ： The results showed that VAS, Ramesay score and MBS had no significant difference （ P 〉 0.05 ） among the groups. During the epidureal analgesia, all group patients were. The patients＇ heart rate and blood pressure had no significant difference （ P 〉0. 05）. In A group, 3 case appeared the leg numbness. Fortunately, there were no other significant side effects happen after the statistics analysis. Conclusion ：After caesarean operation, Cgroup recipe （0.15 % ropivaeaine combine with 5mg midazolain and 0.2mg fentanyl） can offer last favorable analgesic effects,minor dosage,less side effects and high safety and is a better analgesia method.
出处
《医学信息（中旬刊）》
2011年第7期2867-2868,共2页
Medical Information Operations Sciences Fascicule
