目的观察经皮肝肿瘤射频消融术中罗哌卡因持续硬膜外输注的镇痛效果。方法 90例肝肿瘤患者给予0.2%罗哌卡因硬外麻醉,首量10 m L,持续硬外泵注,随机分3组,每组30例。A组为4 m L·h~(-1) ;B组为6 m L·h~(-1) ;C组为8 m L·h~(-1) 。记录患者T0(术前)、T1(切皮)、T2(消融)、T3(术毕)时MAP、HR、Sp O2、ADR和视觉模拟评分(VAS)。结果与A组比较,B组、C组患者于T2、T3时MAP、HR、VAS评分显著降低(P<0.05),C组心动过缓例数明显增多(P<0.05);与B组比较,C组患者T1、T2、T3时MAP、HR、ADR显著降低(P<0.05)。结论 0.2%罗哌卡因4 m L·h~(-1) ,6 m L·h~(-1) ,8 m L·h~(-1) 连续硬膜外注射改善射频消融患者镇痛效果,6 m L·h~(-1) 的剂量镇痛更有效更安全。
【英文摘要】
Objective To observe the analgesic efficacy of continuous epidural infusion of 0. 2%ropivacaine in patients with liver neoplasmsundergoing percutaneous radiofrequency ablation. Methods After10 m L of epidural bolus 0. 2% ropivacaine,90 patients with liver neoplasms undergoing percutaneous radiofrequency ablation performed under epidural anesthesia by continuous infusion with three different doses of 0. 2% ropivacaine were randomly divided into 3 groups,30 cases in each group: Group A were given 4 m L·h~(-1)...