CAJ | 학술논문

目的评价0.2％左旋布比卡因切口局部持续镇痛用于剖宫产术后镇痛的效果.方法择期拟行剖宫产术孕妇30例,年龄20 ～ 30岁,体重60 ～ 80 kg,ASA分级Ⅰ或Ⅱ级,术毕采用切口局部持续镇痛装置给予0.2％左旋布比卡因,剂量2 ml/h.采用VAS评分法评价疼痛程度,VAS评分＞3分,追加曲马多50 mg,记录术后48 h内镇痛有效(未追加曲马多,VAS评分≤3分)情况及追加曲马多用量;于术前30 min、术后24和48 h时测定血清泌乳素浓度,记录初乳时间,观察局麻药中毒、不良反应的发生情况.结果术后48 h内镇痛有效率为80％,追加曲马多用量为(95±15) mg,初乳时间为(24±6)h;未见局麻药中毒反应发生.与术前30 min时比较,术后24和48 h时血清泌乳素浓度升高(P＜ 0.05).结论 0.2％左旋布比卡因切口局部持续镇痛用于剖宫产术后镇痛的效果较好,产妇泌乳早,不良反应少.
목적 평개0.2％좌선포비잡인절구국부지속진통용우부궁산술후진통적효과.방법택기의행부궁산술잉부30례,년령20 ～ 30세,체중60 ～ 80 kg,ASA분급Ⅰ혹Ⅱ급,술필채용절구국부지속진통장치급여0.2％좌선포비잡인,제량2 ml/h.채용VAS평분법평개동통정도,VAS평분＞3분,추가곡마다50 mg,기록술후48 h내진통유효(미추가곡마다,VAS평분≤3분)정황급추가곡마다용량;우술전30 min、술후24화48 h시측정혈청비유소농도,기록초유시간,관찰국마약중독、불량반응적발생정황.결과 술후48 h내진통유효솔위80％,추가곡마다용량위(95±15) mg,초유시간위(24±6)h;미견국마약중독반응발생.여술전30 min시비교,술후24화48 h시혈청비유소농도승고(P＜ 0.05).결론 0.2％좌선포비잡인절구국부지속진통용우부궁산술후진통적효과교호,산부비유조,불량반응소.
Objective To evaluate the efficacy of continuous incision analgesia with 0.2％ levobupivacaine for postoperative analgesia in parturients undergoing cesarean section.Methods Thirty ASA physical status Ⅰ or Ⅱ parturients who were at full term,aged 20-30 yr,weighing 60-80 kg,undergoing elective cesarean section,were enrolled in the study.The parturients received 0.2％ levobupivacaine 2 ml/h via a continuous incision analgesia device at the end of surgery.Pain was evaluated by visual analogue scale (VAS).Additional tramadol 50 mg was given when VAS score was above 3 and the consumption was recorded.The effective analgesia within 48 h after surgery (no addition of tramadol,VAS score ≤3) was recorded.The serum prolactin level was measured at 30 min before cesarean section and 24 and 48 h after cesarean section.The colostrum time was recorded.The toxic reaction and side effects were recorded.Results The effective analgesia rate was 80 ％.The consumption of tramadol was (95 ± 15) mg.The colostrum time was (24 ± 6) h.No toxic reaction was found.The serum prolactin level was significantly higher at 24 and 48 h after surgery than that at 30 min before surgery (P ＜ 0.05).Conclusion Continuous incision analgesia with 0.2％ levobupivacaine provides better efficacy,earlier colostrum time and fewer side effects for postoperative analgesia in parturients undergoing cesarean section.