【摘要】 目的 比较不同浓度罗哌卡因复合曲马多用于剖宫产术后持续硬膜外镇痛效果和安全性。方法40例ASA Ⅰ~Ⅱ级行剖宫产术的初产妇,随机分为R0.1和R0.2两组,每组20例。R0.1组镇痛用药为0.1％罗哌卡因+4mg／ml曲马多+8mg恩丹西酮;R0.2组为0.2％罗哌卡因+4mg／ml曲马多+8mg恩丹西酮,用生理盐水稀释至50ml,采用一次性镇痛泵,术毕即予硬膜外腔给药,2ml·h-1。观察24小时内心率、血压、呼吸频率、静息疼痛评分(VAS)、镇静评分(SS)、运动阻滞评分(Bromage评分)的变化以及不良反应的发生率。结果 两组产妇24小时内静息时VAS评分、SS评分均无显著性差异(P>0.05),R0.2组用药30分钟~6小时内Bromage评分大于R0.1组(P<0.05),6小时后两组无显著性差异。R0.1组尿潴留、排气时间延长发生率明显低于R0.2组(P<0.05),恶心呕吐、瘙痒发生率组间无显著性差异。结论 0.1％罗哌卡因复合曲马多用于剖宫产术后硬膜外持续输注镇痛能够取得良好的镇痛效果,感觉-运动阻滞分离效果好,不良反应少。更多还原

【Abstract】 <abstract>jective To evaluate the efficacy and safety of different concentration of ropivacaine combined with tramadol during postoperative continous epidural analgesia after cesarean section. Methods 40 ASAⅠ~Ⅱpatients undergoing cesarean section were randomized into two groups(n=20 in each group). Group R0.1: 0.1% ropivacaine plus 4mg/ml tramadol plus ondansetron 8mg; group R0.2: 0.2% ropivacaine plus 4mg/ml tramadol plus ondansetron 8mg. The drugs in each group were diluted in normal saline 50ml with a disposable perfusion pump of 2ml/h. The changes of heart rate(HR), blood pressure(BP), respiratory rate(RR), VAS, sedation scores(SS), modified Bromage scale, incidences of nausea, vomiting, itching, urinary relention, delayed exsufflation within postoperative 24h were recorded. Results There were no difference between the two groups in the static pain score and the sedation scores. Bromage score of group R0.2 was highter than that of group R0.1 within postoperative 6h(P<0.05). The incidences of urinary retention and delayed exsufflation in group R0.1 were significantly lower then group R0.2(P<0. 05). Conclusion 0.1% ropivacaine combined with Tramadol provides a satisfactory analgesic effect with less complication during postoperative continous epidural analgesia after cesarean section.更多还原