中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2012年
7期
739-741
,共3页
罗哌卡因%地左辛%PCEA%镇痛效果%运动阻滞
囉哌卡因%地左辛%PCEA%鎮痛效果%運動阻滯
라고잡인%지좌신%PCEA%진통효과%운동조체
Ropivacayin%Dezocine%PCEA%Analgesic effect%Motor block
目的 观察不同浓度罗哌卡因配伍地左辛用于下腹PCEA的镇痛效果、运动阻滞的临床观察.方法 选择60例ASAⅠ～Ⅱ级患者采用硬膜外镇痛患者随机分为3组,每组20例.分别予以地佐辛5 mg+0.125％的罗哌卡因+生理盐水稀释至100 ml(DI组)、地佐辛5mg+0.175％罗哌卡因+生理盐水稀释至100 ml(D2组)、地佐辛5mg +0.225％罗哌卡因+生理盐水稀释至100 ml(D3组)进行硬膜外镇痛.利用LCP模式给药,首次给药剂量5 ml,持续剂量2 ml/h,锁定时间为20 min,全程镇痛48 h,观察和记录患者术后镇痛开始后2、4、12、24、48 h视觉模拟法(VAS)评分、Bromage改良运动评分,术后活动能力,术后恶心、呕吐等不良反应发生情况.结果 3组患者年龄,性别比例,体质量,手术时间和术中出血量等差异均无统计学意义(P均＞0.05).术后2、4、12h,D2组、D3组VAS评分明显低于D1组[(2.54±1.34)、(2.47±1.05)分与(3.62±1.02)分,(2.13±1.30)、(2.15±1.28)分与(3.56±1.10)分,(1.03±0.43)、(1.04±0.51)分与(1.92±1.2.0)分]差异均有统计学意义(P均＜0.05).3组Bromage改良运动评分比较,D1组与D2组各时点比较差异均无统计学意义(P均＞0.05),且D1组与D2组Bromage各时点改良运动评分明显低于D3组[(1.21±0.21)、(1.28±0.22)分与(1.53±0.31)分,(1.15±0.15)、(1.44±0.25)分与(1.61±0.12)分,(0.92±0.14)、(0.99±0.13)分与(1.71±0.22),(0.85±0.11)、(0.88±0.14)分与(1.66±0.15)分,(0.42±0.10)、(0.55±0.09)分与(1.19±0.11)分](P均＜0.05).3组分别出现2例,2例,3例恶心呕吐(P＞0.05),无其他不良反应.结论 0.175％罗哌卡因配伍地左辛5 mg用于下腹手术后镇痛效果满意,且有利于患者早期下床活动.
目的 觀察不同濃度囉哌卡因配伍地左辛用于下腹PCEA的鎮痛效果、運動阻滯的臨床觀察.方法 選擇60例ASAⅠ～Ⅱ級患者採用硬膜外鎮痛患者隨機分為3組,每組20例.分彆予以地佐辛5 mg+0.125％的囉哌卡因+生理鹽水稀釋至100 ml(DI組)、地佐辛5mg+0.175％囉哌卡因+生理鹽水稀釋至100 ml(D2組)、地佐辛5mg +0.225％囉哌卡因+生理鹽水稀釋至100 ml(D3組)進行硬膜外鎮痛.利用LCP模式給藥,首次給藥劑量5 ml,持續劑量2 ml/h,鎖定時間為20 min,全程鎮痛48 h,觀察和記錄患者術後鎮痛開始後2、4、12、24、48 h視覺模擬法(VAS)評分、Bromage改良運動評分,術後活動能力,術後噁心、嘔吐等不良反應髮生情況.結果 3組患者年齡,性彆比例,體質量,手術時間和術中齣血量等差異均無統計學意義(P均＞0.05).術後2、4、12h,D2組、D3組VAS評分明顯低于D1組[(2.54±1.34)、(2.47±1.05)分與(3.62±1.02)分,(2.13±1.30)、(2.15±1.28)分與(3.56±1.10)分,(1.03±0.43)、(1.04±0.51)分與(1.92±1.2.0)分]差異均有統計學意義(P均＜0.05).3組Bromage改良運動評分比較,D1組與D2組各時點比較差異均無統計學意義(P均＞0.05),且D1組與D2組Bromage各時點改良運動評分明顯低于D3組[(1.21±0.21)、(1.28±0.22)分與(1.53±0.31)分,(1.15±0.15)、(1.44±0.25)分與(1.61±0.12)分,(0.92±0.14)、(0.99±0.13)分與(1.71±0.22),(0.85±0.11)、(0.88±0.14)分與(1.66±0.15)分,(0.42±0.10)、(0.55±0.09)分與(1.19±0.11)分](P均＜0.05).3組分彆齣現2例,2例,3例噁心嘔吐(P＞0.05),無其他不良反應.結論 0.175％囉哌卡因配伍地左辛5 mg用于下腹手術後鎮痛效果滿意,且有利于患者早期下床活動.
목적 관찰불동농도라고잡인배오지좌신용우하복PCEA적진통효과、운동조체적림상관찰.방법 선택60례ASAⅠ～Ⅱ급환자채용경막외진통환자수궤분위3조,매조20례.분별여이지좌신5 mg+0.125％적라고잡인+생리염수희석지100 ml(DI조)、지좌신5mg+0.175％라고잡인+생리염수희석지100 ml(D2조)、지좌신5mg +0.225％라고잡인+생리염수희석지100 ml(D3조)진행경막외진통.이용LCP모식급약,수차급약제량5 ml,지속제량2 ml/h,쇄정시간위20 min,전정진통48 h,관찰화기록환자술후진통개시후2、4、12、24、48 h시각모의법(VAS)평분、Bromage개량운동평분,술후활동능력,술후악심、구토등불량반응발생정황.결과 3조환자년령,성별비례,체질량,수술시간화술중출혈량등차이균무통계학의의(P균＞0.05).술후2、4、12h,D2조、D3조VAS평분명현저우D1조[(2.54±1.34)、(2.47±1.05)분여(3.62±1.02)분,(2.13±1.30)、(2.15±1.28)분여(3.56±1.10)분,(1.03±0.43)、(1.04±0.51)분여(1.92±1.2.0)분]차이균유통계학의의(P균＜0.05).3조Bromage개량운동평분비교,D1조여D2조각시점비교차이균무통계학의의(P균＞0.05),차D1조여D2조Bromage각시점개량운동평분명현저우D3조[(1.21±0.21)、(1.28±0.22)분여(1.53±0.31)분,(1.15±0.15)、(1.44±0.25)분여(1.61±0.12)분,(0.92±0.14)、(0.99±0.13)분여(1.71±0.22),(0.85±0.11)、(0.88±0.14)분여(1.66±0.15)분,(0.42±0.10)、(0.55±0.09)분여(1.19±0.11)분](P균＜0.05).3조분별출현2례,2례,3례악심구토(P＞0.05),무기타불량반응.결론 0.175％라고잡인배오지좌신5 mg용우하복수술후진통효과만의,차유리우환자조기하상활동.
Objective To investigate the analgesic effect and motor block of ropivacayin combined dezocine in lower abodiminal operation.Methods Sixty patients of ASA Ⅰ - Ⅱ were divided into three groups randomly(n =20 for each group).They were treated with dezocine 5 mg +0.125％ ropivacayin/100 ml( group DI ),dezocine 5 mg +0.175％ ropivacayin/100 ml( group D2),dezocine 5 mg +0.225％ ropivacayin/100 ml (group D3 ).The initial dose was 5 ml,and the maintenance dose was 2 ml/h,with lock-out time of 20 mins,and the duration of patient-controlled epidermal analgesia (PCEA) was 48 h.The analgesic effect was evaluted by VAS score at 2,4,12,24 and 48 h after surgery.Bromage score and the side effects such as motor ability,and vomiting after surgery were recorded.Results At 2,4,12 h after surgery,the VAS scores of group D2 and D3 were less than that of group D1 (2.54 ± 1.34,2.47 ± 1.05 and 3.62 ± 1.02 at 2 hrs,2.13 ± 1.30,2.15 ± 1.28 and 3.56 ± 1.10 at 4 hrs,1.03 ± 0.43,1.04 ± 0.51 and 1.92 ± 1.20 at 12 hrs,respectively) ( Ps ＜ 0.05 ).As for the Bromage score among the 3 groups,there were no sighificant diffrences between group D1 and D2,wheras they were significantly lower than that in group D3 ( 1.21 ± 0.21,1.28 ±0.22 and 1.53 ± 0.31 at 2 hrs,1.15 ± 0.15,1.44 ± 0.25 and 1.61 ± 0.12 at 4 hrs,0.92 ± 0.14,0.99 ± 0.13 and 1.71 ± 0.22 at 12 hrs,0.85 ± 0.11,0.88±0.14 and (1.66±0.15) at 24 hrs,0.42 ± 0.10,0.55 ± 0.09 and 1.19±0.11 at 48 hrs,respectively,Ps ＜0.05).There were 2,2 and 3 patients affected with nausea and vomiting among the 3 groups,and there were no other side effects ( P ＞ 0.05 ).Conclusion 0.175％ ropivacayin combined with dezocine 5 mg via PCEA in lower abodiminal operation shows better analgesic effect and benefical to the restoration of lower limbs movements.
