中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2008年
21期
17-19
,共3页
李秀英%陶敏%阎俊新%赵亚伟
李秀英%陶敏%閻俊新%趙亞偉
리수영%도민%염준신%조아위
剖宫产术%镇痛,硬膜外%甲磺酸罗哌卡因%盐酸奈福泮%曲马多
剖宮產術%鎮痛,硬膜外%甲磺痠囉哌卡因%鹽痠奈福泮%麯馬多
부궁산술%진통,경막외%갑광산라고잡인%염산내복반%곡마다
Cesarean section%Analgesia,epidural%Ropivacaine mesylate%Nefopam hydrochloride%Tramadol
目的 比较剖宫产术后两种硬膜外自控镇痛效果及恶心呕吐、嗜睡、尿潴留发生率.方法 60例剖宫产患者随机分成两组,每组各30例,术毕分别接硬膜外自控镇痛泵.I组:0.15%盐酸布比卡因加曲马多;Ⅱ组:0.179%甲磺酸罗哌卡因加盐酸奈福泮,观察并记录术后48 h内各时点的视觉模拟评分(VAS)和对应时点下肢运动阻滞程度(Bromage评分)及术后恶心呕吐、嗜睡、尿潴留等不良反应发生率.结果 两组术后6、12、24、36 h VAS比较差异无统计学意义(P>0.05);Bro-Inage评分Ⅰ组各时点分别为(2.75±0.49)分、(1.51±0.42)分、(0.92±1.08)分、(0.89±0.12)分,Ⅱ组分别为(1.31±0.57)分、(0.35±0.31)分、(0.08±0.30)分、(0.06±0.28)分,两组比较差异有统计学意作者单位:252601 山东临清,聊城市第二人民医院麻醉科义(P<0.05);恶心呕吐、嗜睡、尿潴留发生率Ⅰ组分别为16.7%、13.3%、50.0%,Ⅱ组分别为6.7%、3.3%、10.0%,两组比较差异有统计学意义(P<0.01).结论 甲磺酸罗哌卡因复合盐酸奈福泮行硬膜外自控镇痛效果确切,在运动功能恢复,降低恶心呕吐、嗜睡、尿潴留发生率方面显示明显优越性.
目的 比較剖宮產術後兩種硬膜外自控鎮痛效果及噁心嘔吐、嗜睡、尿潴留髮生率.方法 60例剖宮產患者隨機分成兩組,每組各30例,術畢分彆接硬膜外自控鎮痛泵.I組:0.15%鹽痠佈比卡因加麯馬多;Ⅱ組:0.179%甲磺痠囉哌卡因加鹽痠奈福泮,觀察併記錄術後48 h內各時點的視覺模擬評分(VAS)和對應時點下肢運動阻滯程度(Bromage評分)及術後噁心嘔吐、嗜睡、尿潴留等不良反應髮生率.結果 兩組術後6、12、24、36 h VAS比較差異無統計學意義(P>0.05);Bro-Inage評分Ⅰ組各時點分彆為(2.75±0.49)分、(1.51±0.42)分、(0.92±1.08)分、(0.89±0.12)分,Ⅱ組分彆為(1.31±0.57)分、(0.35±0.31)分、(0.08±0.30)分、(0.06±0.28)分,兩組比較差異有統計學意作者單位:252601 山東臨清,聊城市第二人民醫院痳醉科義(P<0.05);噁心嘔吐、嗜睡、尿潴留髮生率Ⅰ組分彆為16.7%、13.3%、50.0%,Ⅱ組分彆為6.7%、3.3%、10.0%,兩組比較差異有統計學意義(P<0.01).結論 甲磺痠囉哌卡因複閤鹽痠奈福泮行硬膜外自控鎮痛效果確切,在運動功能恢複,降低噁心嘔吐、嗜睡、尿潴留髮生率方麵顯示明顯優越性.
목적 비교부궁산술후량충경막외자공진통효과급악심구토、기수、뇨저류발생솔.방법 60례부궁산환자수궤분성량조,매조각30례,술필분별접경막외자공진통빙.I조:0.15%염산포비잡인가곡마다;Ⅱ조:0.179%갑광산라고잡인가염산내복반,관찰병기록술후48 h내각시점적시각모의평분(VAS)화대응시점하지운동조체정도(Bromage평분)급술후악심구토、기수、뇨저류등불량반응발생솔.결과 량조술후6、12、24、36 h VAS비교차이무통계학의의(P>0.05);Bro-Inage평분Ⅰ조각시점분별위(2.75±0.49)분、(1.51±0.42)분、(0.92±1.08)분、(0.89±0.12)분,Ⅱ조분별위(1.31±0.57)분、(0.35±0.31)분、(0.08±0.30)분、(0.06±0.28)분,량조비교차이유통계학의작자단위:252601 산동림청,료성시제이인민의원마취과의(P<0.05);악심구토、기수、뇨저류발생솔Ⅰ조분별위16.7%、13.3%、50.0%,Ⅱ조분별위6.7%、3.3%、10.0%,량조비교차이유통계학의의(P<0.01).결론 갑광산라고잡인복합염산내복반행경막외자공진통효과학절,재운동공능회복,강저악심구토、기수、뇨저류발생솔방면현시명현우월성.
Objective To compare the effects of two patient-controlled epidural analgesia(PCEA) after cesarean section and the incidence of nausea vomiting, lethargy and urinary retention. Methods Sixty cesarean section patients were randomly divided into two groups, each group had 30 patients. Group Ⅰ: 0.15% bupivacaine hydrochloride plus tramadoL group Ⅱ: 0.179% ropivacaine mesylate plus nefopam hydrochloride. Postoperative 0-48 hours within the period pain (visual analog score, VAS)and the corresponding time motor block level(the Bromage scale), and incidence of nausea vomiting, lethargy and urinary retention were recorded. Results VAS difference was not statistically significant (P>0.05), Bromage scores in group Ⅱ was shorter than those in group Ⅰ(P<0.05), the incidence rates of nausea vomiting, lethargy and urinary retention in group Ⅱ were lower than those in group Ⅰ(P<0.01). Conclusion Ropivacaine mesylate combined with nefopam hydrochloride PCEA analgesic effect is certain, which shows a clear superiority in the motor function recovery and reducing the incidence of adverse reactions.
