【摘要】 目的:研究国产氯普鲁卡因用于术后硬膜外镇痛的临床效果。方法:选择30例低位横切口剖宫产、30例经腹子宫切除和45例下肢骨科手术患者,随机分为产科A1(n=15)、A2(n=15),妇科A1(n=15)、A2(n=15),骨科A1(n=15)、A2(n=15)、A3(n=15)组。术后给予硬膜外持续镇痛。A1组为1%氯普鲁卡因,A2组为1.2%氯普鲁卡因,A3组为1.2%氯普鲁卡因+2μg/ml芬太尼。结果:①产科、妇科术后镇痛效果较好,VAS平均低于20,1.2%氯普鲁卡因更令人满意。②骨科A1组镇痛效果较差,VAS在31.1±5.9~60.6±12.4之间,有9例诉求3%氯普鲁卡因5ml+吗啡1mg硬膜外额外用药一次,4例诉求2次。A2组VAS维持在8.1±1.5~25.7±5.8之间,明显比A1组低(P<0.01)。A3组VAS则比A2组又低,且无额外镇痛诉求。③硬膜外镇痛取代硬膜外麻醉后,Bromage运动阻滞评级均为0级。结论:氯普鲁卡因硬膜外阻滞能有效地解除术后疼痛。不同的手术应选择不同的浓度。更多还原

【Abstract】 Objective:To investigate the analgesic effects of domestic chloroprocaine for epidural block after operation. Methods: 30 patients undergoing transverse caesarean section, 30 patients abdominal hysterectomy and 45 patients orthopaedics of lower limbs, were randomly divided into A1(n=15) and A2(n=15)groups of obstetrics, A1(n=15) and A2(n=15)groups of gynaecology, A1(n=15), A2(n=15) and A3(n=15)groups of orthopaedics. All patients were administered continuous epidural anesthesia with 1% chloroprocaine(A1) or 1.2% chloroprocaine(A2) or 1.2% chloroprocaine +2μg/ml fentanyl(A3). Results: In the obstetrics group and gynaecology group the post-operative pain relief was satisfactory; Mean VAS was less than 20; 1.2% chloroprocaine had better effect. In orthopaedics A1, the VAS ranged from 31.15.9 to 60.612.4; 9 patients asked for an additional epidural bolus of 3% chloroprocaine 5ml + morphine 1mg, and 4 patients were given twice. The VAS was 8.11.5~25.75.8 in orthopaedics A2, which were significantly lower (P<0.01) than that in orthopaedics A1. The VAS was even lower in orthopaedics A3 and none asked for an additional analgesic. No movement disorders were observed. Conclusion: The post-operative pain could be relieved by continuous epidural anesthesia with chloroprocaine; the selected concentration levels are dependent on the kind of operation.更多还原