【摘要】 本工作观察低浓度布比卡因与小剂量丁丙诺啡、吗啡复合液病人自控硬膜外镇痛（ＰＣＥＡ）的临床效应。４００例病人分为两组，Ⅰ组（ｎ＝７８）丁布溶液：０．１２５％～０．２５％布比卡因＋０．００１５％丁丙诺啡；Ⅱ组（ｎ＝３２２）吗丁布溶液：同Ⅰ组丁布溶液＋０．００５％吗啡；均采用Ｇｒａｓｅｂｙ３３００型ＰＣＡ泵，以ＬＣＰ模式（负荷剂量＋持续量＋ＰＣＡ）给药。结果：Ⅰ组和Ⅱ组首２０ｈ镇痛用药量分别为２１．７±６．１ｍｌ（丁丙诺啡０．３３±０．０９ｍｇ）和１９．５±５．７ｍｌ（丁丙诺啡０．３０±０．０９ｍｇ、吗啡１．０±０．２９ｍｇ），ＶＡＳ评级为１．２±０．５和１．０±０．３分。二组呕吐并发症分别为１．３％和２．５％，无呼吸抑制或瘙痒情况。结论：本配伍ＰＣＥＡ临床效果好，并发症少，是一种安全有效的镇痛方式。更多还原

【Abstract】 Patient controlled analgesis(PCA)hat become a popular alternative to conven tional postoperative analgesic technique with intravenous injections.Patient controlled epidu ral analgesia(PCEA)is a relatively new method for pain relief using different complex of buprenorphine infusion. We designed this stagy to determine the safety and efficacy of PCEA therapy in abdominal surgely.The effects in relieving petoperative acute pain wereobserved by the PCEA with lower consistency bupivacaine and small dose buprenorphine orplus morphine complex infusion.400 surgical patients(ASA Ⅰ-Ⅲ)were divided randomly intwo groups.Group Ⅰ(n=78)received PCEA with 0.125%-0.25% bupivcaine plus0.0015% buprenorphine and a loading dose of 5ml.Group Ⅱ(n=322)received PCEA withinfusion used in group Ⅰ plus 0.005% morphine and a loading dose of 5ml. Graseby 3300PCA pump was used.The resultS showed that the dose of complex infusion for relievingpostoperative pain in group Ⅰ and Ⅱ were 21.7±6.1ml(buprenorphine 0.33±0.09mg)and 19.5±5.7ml(buprenorphine 0.3±0.09mg and morphine 1.0±0.29mg)in first 20hours.The mean visual analogue scores were 1.2±0.5 and 1.0±0.3 respectively.Side e ffects of nause was 1.3% and 2.5% respectively.No respiratory depression and itching wasobserved.Conclusions:PCEA is a method of good clinical effect and low side effects.Effec tive and safe postoperative analgesia can be achieved in Chinese patients with currently avail able pain control techniques such as PCEA.更多还原