摘要
目的观察右旋美托咪啶对0.2%罗哌卡因配伍0.1%喷他佐辛硬膜外患者自控镇痛(PCA)用于经腹子宫全切术后患者的镇痛效应的影响。方法 120例择期经腹子宫全切术患者随机分成P1、P2、P3组(n=40),均采用0.2%罗哌卡因配伍0.1%喷他佐辛的配药方式,镇痛泵模式为负荷剂量(LD)+持续输注剂量(CI)+PCA追加剂量(Bolus)模式(LCP模式)行硬膜外患者自控镇痛(PCEA);P1、P2组负荷剂量为生理盐水5ml,P3组为静脉注射右旋美托咪啶0.5μg/kg共5ml,P1组及P3组采用持续剂量(1ml)+PCA追加剂量(3ml),P2组采用持续剂量(2ml)+PCA追加剂量(2ml),分别记录患者运动阻滞功能恢复至0级时间及各组患者硬膜外用药量,以及开启PCA泵后1h、2h、4h、8h、16h、24h各时点的VAS评分,记录患者对PCA的综合满意度及不良反应。结果与P1组比较,P3组患者运动阻滞时间延长、硬膜外药物用量减少、寒颤的发生率降低(P<0.05);各时段VAS评分P2、P3组低于P1组(P<0.05),P2、P3组比较差异无统计学意义(P﹥0.05)。结论硬膜外单次注射右旋美托咪啶0.5ug/kg能增强罗哌卡因配伍喷他佐辛的硬膜外镇痛效应,降低硬膜外用药量及降低寒颤等不良反应的发生率。
Objective To investigate the effect ofdexmedetomidine on the analgesic effect of postoperative patient-controlled epidural analgegia （PCEA） using 0. 1% pentazocine and 0.2% ropivacaine after transabdominal hys- terectomy. Methods One hundred and twenty patients undergoing transabdominal hysterectomy were divided ran- domly into three groups： group PI, P2, P3 （n=40）. Patients in the three groups all received postoperative patient-con- trolled ~pidural analgegia （PCEA） using 0.1% pentazocine added to 0.2% ropivacaine. The model of PCA was LCP with loading dose （LD, dexmedetomidine 0.5 μg/kg or Physiological saline） 5 ml＋ continue infusion dose （CI） I ml＋ bolus dose 3 ml in group P1 or P3, and that with LD （Physiological saline） 5 ml＋CI 2 ml＋bolus dose 2 ml in group P2. The total dosage of ropivacaine and pentazocine, the duration of motor block, VAS score of wound pain l h, 2 h, 4 h, 8 h, 16 h, 24 h after PCA pump and adverse effects were recorded. Results The total dosage of ropivacaine and pentazo- cine in group P3 was significantly lesser than group Pl （P〈0.05）. Duration time of motor block with Group P3 was sig- nificantly shorter and incidence of shiver was significantly lower than those in Group PI （P〈0.05）. VAS of wound pain in group P2, P3 was lower than that in group PI （P〈0.05）, while that in group P2, P3 showed no statistically sig- nificant difference （P〉0.05）. Conclusion Dexmedetomidine 0.5 lag/kg given by epidural injection improves the qual- ity and the duration of postoperative analgesia, and also provides an analgesic sparing effect in patients undergoing transabdominal hysterectomy.
出处
《海南医学》
CAS
2013年第12期1764-1766,共3页
Hainan Medical Journal
关键词
镇痛
患者自控
硬膜外
右旋美托咪啶
罗哌卡因
喷他佐辛
Patient-controlled epidural analgesia （PCEA）
Dexmedetomidine
Ropivocaine
Pentazocine
