《中国康复理论与实践》

《中国康复理论与实践》 ›› 2005, Vol. 11 ›› Issue (03): 222-223.

• 临床研究 • 上一篇    下一篇

罗哌卡因和布比卡因分别复合芬太尼应用于术后硬膜外镇痛的比较研究

李之明1; 刘超2; 张东亚1   

  1. 清华大学第一附属医院麻醉科 北京市 100016;2.北京仁和医院麻醉科 北京市 102600
  • 收稿日期:2004-10-13 出版日期:2005-03-25 发布日期:2005-03-25

Comparison between ropivacaine or bupivacaine combined with fentanyl respectively for postoperative continuous epidural analgesia

LI Zhi-ming,LIU Chao,ZHANG Dong-ya   

  1. Department of Anesthesia, the First Affiliated Hospital of Qinghua University, Beijing 100016, China
  • Received:2004-10-13 Published:2005-03-25 Online:2005-03-25

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被引次数

18

摘要： 目的比较罗哌卡因和布比卡因分别复合芬太尼用于术后持续硬膜外镇痛(CEA)的临床效果。方法硬膜外麻醉行下腹部手术、美国麻醉医师学会(American Society of Anesthesiologists,ASA)分级Ⅰ～Ⅱ级的50例患者,随机分为罗哌卡因复合芬太尼(RF)组和布比卡因复合芬太尼(BF)组,每组25例。手术结束前5min硬膜外腔注入负荷剂量,RF组为02%罗哌卡因+5μg/ml芬太尼5ml,BF组为02%布比卡因+5μg/ml芬太尼5ml。术毕,经硬膜外管持续泵入药物2ml/h,RF组为02%罗哌卡因+2μg/ml芬太尼,BF组为02%布比卡因+2μg/ml芬太尼。记录启用止痛泵后1h、4h、8h、24h、48h的视觉模拟评分法(VAS)评分、改良Bromage分级。结果50例患者启用止痛泵后48h内生命体征平稳。各时段的VAS评分两组间无显著性差异(P>005);但改良Bromage分级RF组低于BF组(P<005)。结论罗哌卡因和布比卡因分别复合芬太尼用于术后持续硬膜外镇痛均可取得良好的镇痛效果,而罗哌卡因对运动神经的阻滞较轻,效果更理想。

关键词: 罗哌卡因, 布比卡因, 芬太尼, 持续硬膜外镇痛

Abstract: ObjectiveTo compare the clinical effect of 0.2% ropivacaine and bupivacaine combined with fentanyl respectively for postoperative continuous epidural analgesia(CEA).Methods50 patients of American Society of Anesthesiologists(ASA) grade Ⅰ~Ⅱ after abdomen operation were divided randomly into group ropivacaine + fentanyl(RF) and bupivacaine + fentanyl(BF). 5min before operation finished, group RF was given 0.2% ropivacaine plus 5 μg/ml fentanyl 5 ml, group BF was given 0.2% bupivacaine plus 5μg/ml fentanyl 5ml, and followed by a continuous infusion of 0.2% ropivacaine or bupivacaine plus 2 μg/ml fentanyl 2 ml/h at the end of operation respectively. The analgesic and paralytic effects expressed in VAS and modified Bromage degrees respectively were recorded 1h, 8h, 24h and 48h after operation.ResultsThere were no significant difference between group RF and group BF in VAS scales(P>0.05), but there were significant difference between group RF and group BF in modified Bromage degrees (P<0.05).ConclusionRopivacaine and bupivacaine combined with fentanyl could be safely and effectively used for postoperative analgesia. Because of the lower incidence of complications, ropivacaine combined with fentanyl will be more satisfactory.

Key words: ropivacaine, bupivacaine, fentanyl, continues epidural analgesia