【摘要】 目的:比较罗哌卡因伍用哌替啶、吗啡或曲马朵用于术后硬膜外自控镇痛 (PCEA)的效果及不良反应。方法:选择美国标准协会(ASA)Ⅰ~Ⅱ级、年龄为 18~60岁、择期行下腹部或下肢手术的患者 90例,随机分为罗哌卡因复合哌替啶(A组)、复合吗啡(B组)和复合曲马朵(C组)三组各 30例,分别于用药后 4、8、16、24和 48h观察血压、心率、脉搏血氧(SpO2 )、疼痛视觉模拟评分 (VAS)、Ramsay镇静评分及不良反应。　结果:A组的镇痛效果明显优于B组和C组(P<0. 05),而B组与C组相比的差异无显著性意义(P>0. 05)。C组Ramsay镇静评分明显大于A组和B组(P<0. 05)。三组患者均无明显的呼吸抑制, B组有 2例发生瘙痒,C组 50%的患者出现多汗;三组患者恶心、呕吐的发生率分别是 6. 7%和 10. 0%, 50. 0%和 56. 6%, 53. 3%和 56. 6%。　结论:罗哌卡因复合哌替啶用于术后PCEA的效果优于罗哌卡因复合吗啡或曲马朵,而且其不良反应少,是一种能获得平衡镇痛的较好方法。更多还原

【Abstract】 Objective: To compare the analgesic effects and aversive side effects of ropivacaine combined with pethidine、morphine or tramadol for postoperative patient control epidural analgesia(PCEA). Methods: Ninety ASA physical status Ⅰ-Ⅱ patients scheduled for elective abdominal or legs surgeries were randomly divided into three groups: Group A, ropivacaine 200 mg+pethidine 50 mg +ondansetron 4 mg; Group B, ropivacaine 200 mg+morphine 5 mg +ondansetron 4 mg; Group C, ropivacaine 200 mg+tramadol 600 mg +ondansetron 4 mg. The visual analogue scale(VAS),Ramsay sedation scores,HR,BP,SpO 2and adverse effects were observed at 4,8,16,24,48 hours after operation. Results:VAS in group A was lower than that in group B and C (P<0.05) and VAS in group B and C were not different(P>0.05). Ramsay sedation scores of group C were significantly higher than those of group A and group B (P<0.05). There was no respiratory arrest in three groups. Incidences of nausea, vomiting in group A were lower than those in group B and C. Conclusion: Ropivacaine combined with pethidine for postoperative PCEA has a better analgesic effect than ropivacaine combined with morphine or tramadol.更多还原