【摘要】 目的　观察硬膜外预注不同剂量可乐定对术后PCEA的影响。方法　 6 0例择期妇科手术患者采用硬膜外麻醉方法 ,随机等分 4组 :R0 组为术前硬膜外单纯罗哌卡因药物 2 5ml;R50 组含 5 0 μg可乐定 ;R10 0 组含 10 0 μg可乐定 ;R150 组含 15 0 μg可乐定。PCEA配方为 0 .2 %罗哌卡因 10 0ml +吗啡 10mg +氟哌啶 3 .5mg ,自控量 3ml/次 (吗啡0 3mg/次 ) ,锁定时间 10min ,4h限量 40ml。记录术后镇痛效果及其他不良反应 ,围手术期血清皮质醇浓度。结果　 4组患者术后镇痛效果相同 (P >0 .0 5 ) ;术后第一疼痛时间R10 0 和R150 组有明显延长 (P <0 0 5 ) ;术后 2 4h总药量、围手术期血清皮质醇水平变化、术后镇痛副作用组间比较差异均无显著性 (P >0 .0 5 )。结论　可乐定在 5 0～ 15 0 μg剂量范围内 ,临床上表现无确切的超前镇痛效应 ,对术后PCEA效果无明显的影响更多还原

【Abstract】 Objective To investigate the effect of epidural clonidine premedication on efficacy of postoperative PCEA. Methods 60 adult patients (ASA Ⅰ～Ⅱ) undergoing gynecological surgery were randomized into four groups, each of 15 patients: epidural block with 0 75% ropivacaine 25 ml (R 0 group), the other three were ropivacaine combined with clonidine 50,100 and 150 μg (R 50 , R 100 , R 150 group). Analgesia pump formula of PCEA was 0 2% ropivacaine 100 ml+morphine 10 mg+droperidol 3.5 mg, bolus 3 ml, lockout time 10 min, the limited dose within 4 h ours was 40 ml. Pain scales (VAS) and adverse effects were recorded, serum cortisol concentration was measured at perioperative. Results There was same and satisfactory pain relief in four groups ( P >0 05), time to the first PCEA was significantly prolonged in group R 100 and R 150 in comparison with group R 0 ( P <0 05); There was no significant difference in the consumption of analgesics in 2 4 h after operation, side effects, serum cortisol concentration among the groups. Clonclusion Epidural clonidine premedication have an uncertain effect on preemptive analgesia, and have no effect on PCEA after gynecological surgery between the dosapes of 50～150 μg.更多还原