摘要
目的:观察0.125%左旋布比卡因(LBUP)、0.125%盐酸罗哌卡因(ROP)、1.8%氯普鲁卡因(CH)用于持续硬膜外自控镇痛(PCEA)的效果。方法:75例下腹部手术ASAⅠ～Ⅱ级患者随机分为LBUP组(L组)、ROP组(R组)、CH组3组,每组25例,L组0.125%左旋布比卡因、R组0.125%罗哌卡因、CH组1.8%氯普鲁卡因,各组均加入40μg舒芬太尼,采用PCEA,设置为负荷剂量(5mL)+持续剂量(2mL/h)+PCA剂量(2mL/次),时间10min,镇痛时间48h。观察并比较3组PCEA期间4、8、12、24、48h的视觉模拟评分(VAS)、布氏(BCS)舒适评分、Ramsay镇静评分、Prince-Henry评分、Bromage评分情况。结果:3组患者术中硬膜外用药剂量、术中辅助用药剂量及手术时间差异均无统计学意义(P>0.05);3组的镇痛效果均满意,VAS、BCS、Ramsay、Prince-Henry评分差异均无统计学意义(P>0.05),L组术后4、8hBromage评分达到0级者分别为32%、44%,明显低于R(60%、60%)、CH组(52%、52%)(P<0.05～0.01),术后12h后各组差异无统计学意义(P>0.05)。结论:3组镇痛效果相似,但盐酸罗哌卡因、氯普鲁卡因运动阻滞恢复时间较快,更利于术后患者运动功能的恢复。
Objective： To investigate the analgesic efficacy and safety of continuous epidural infusion of 0.125% levobupivacaine,0.125% ropivacaine and 1.8% chlorprocaine in patients undergoing lower abdominal surgery.Methods：Seventy-five ASAⅠ-Ⅱpatients undergoing lower abdominal operation under epidural anesthesia were randomly divided into three groups： group L levobupivacaine（n=25）,group R ropivacaine（n=25）,group CH chlorprocaine（n=25）,and was given PCEA as following regimen： a loading dose（5 mL） ＋ continuous dose（2 mL / h） ＋ PCA（2 mL / second） for a period of 48 h.Observed and compared visual analog scale（VAS）,Brinell（BCS） comfort score Ramsay sedation score,Prince-Henry score,Bromage score at 4 th,8 th,12 th,24 th,and 48 th h of the three groups.Results：There was no significant difference in the dosage of consumed drugs,or operation time（P0.05）.The analgesia was satisfactory in three groups,no significant difference in VAS BCS、Ramsay、Prince-Henry scores was found among the three groups.32% and 44% of patients in group L showed Bromage score of zero at 4th and 8th h of PCEA,significant lower than the 60% 60% in group R and 52% 52% in group CH（P0.05~0.01）.No significant difference in scores at 12 h was found（P0.05）.Conclusions： Epidural infusion of 0.125% levobupivacaine,0.125% ropivacaine and 1.8% chlorprocaine are satisfactory for postoperative analgesia.But recovery of motor block produced by levobupivacaine is quicker than that produced by ropivacaine and chlorprocaine,therefore it＇s better for postoperative recovery of motor function.
出处
《海南医学院学报》
CAS
2012年第4期548-550,553,共4页
Journal of Hainan Medical University
基金
中国高校医学期刊临床专项资金项目(112210114)~~
