【摘要】 目的 :观察不同浓度罗哌卡因用于中下腹部手术术后硬膜外自控镇痛效果和安全性。方法 :择期中下腹手术患者 60例 ,随机分A、B、C 3组 ,每组 2 0例。A组给予 0 .2 %罗哌卡因 ,B组给予 0 .2 5 %罗哌卡因 ,C组给予 0 .12 5 %布比卡因加吗啡 6mg加 0 .9%氯化钠注射液共 60mL。A、B组自控镇痛负荷量为 1mL ,维持量为 4～ 6mL·h 1 ,患者自控量每次 1mL ,C组相应参数为 3mL ,1mL·h 1 ,每次 0 .5mL。采用疼痛目视模拟标尺法 (VAS) [分为安静下 (R VAS)、咳嗽时 (C VAS) ]评分间接评估各组麻醉镇痛效果 ,观察下肢运动阻滞程度 (改良Bromage评分 ) ,镇痛期间循环状态及不良反应。结果 :3组R VAS评分差异无显著性 ,C VAS评分B组最佳 ,A、C两组次之。B组下肢麻软发生率 2 5 .0 % ,A、C两组均无 ;C组恶心、呕吐发生率 40 .0 % ,眩晕发生率 5 5 .0 % ,皮肤瘙痒发生率 3 5 .0 % ,A、B组均无。结论 :0 .2 %和 0 .2 5 %罗哌卡因用于下腹手术后硬膜外自控镇痛效果良好 ,0 .2 %罗哌卡因比 0 .2 5 %罗哌卡因更为安全。更多还原

【Abstract】 Objective:To compare epidural analgesia effect s of ropivacaine with different concentrations after lower abdomen surgery. Methods:Sixty patients (ASAI-II) scheduled to lower abd omen surgery were divided into three groups evenly: group A was treated with 0.2 % ropivacaine, group B with 0.25% ropivacaine, and group C with 0.125% bupivacai ne and morphine 6mg disolved in 60 mL sodium chloride injection. The analgesia e ffects in the three groups were valued by visual analog scale (VAS) scores at re st (R-VAS) and at coughing (C-VAS). The moving blockage of lower limbs (modifi ed Bromage scale scores), blood circulation, and adverse drug reaction were obse rved. Results:There was no significant difference in VAS score s at rest among three groups. VAS scores in group B at coughing was lower than t hat in group A and C. The rate of lower limbs being weak in group B was 55%; non e in group A and C. The rates of nausea and vomiting, of dizziness and of itch r espectively were 40%, 55% and 35%; none in group A and B. Conclusion:Epidural analgesia with ropivacaine after low er abdomen surgery is effective, and 0.2% ropivacaine is better and safer than 0 .25% ropivacaine.更多还原