泵速对剖宫产术后硬膜外镇痛效果的影响.docVIP

泵速对剖宫产术后硬膜外镇痛效果的影响 【摘要】目的：观察泵速对剖宫产术后硬膜外镇痛效果的影响。方法：60例ASAⅠ～Ⅱ级的剖宫产术病人，均在硬膜外麻醉下完成手术并实行硬膜外术后镇痛，根据泵速不同将病人随机分为三组，每组20例，A组：0.15％布比卡因＋芬太尼0.4mg，100mil泵速2.1mil／h；B 组：0.15％布比卡因＋芬太尼0.4mg，168mil，泵速3.5mil/h；C 组：0.15％ 布比卡因＋芬太尼0.4mg，240mil，泵速 5ml/h。观察病人术后6h、18h、24h、48h，镇痛效果及不良反应。结果：三组患者年龄、体重、手术时间及术中绝对平面无显著性差异（P＞0.05）；术后各时间段B 、C两组VAS评分均低于A组（P＜0.05）；术后24h B、 C两组的阻滞节段数均大于A组（P＜0.05）；三组病人术后镇痛的副作用，C组的下肢麻木发生率较A、B两组高（P＜0.05）。结论：泵速直接影响剖宫产术后硬膜外镇痛效果，3.5mil/h 的泵速既可产生良好的镇痛效果，又不影响病人的下肢活动，可作为首选。 ?【关键词】泵速?? 剖宫产术?? 硬膜外术后镇痛 　　The influence of pump speed to the effects of epidural analgesia after cesarean section 　　Wang Feng-lan1?? Kou Li-hua1?? Li yu-mei1 et al 　（Department of Anesthesiology，Beijing Daxing district people’s hospital，102600，China） ?? 【Abstruct】Objective：To observe the influnce of pump speed to the effect s of epidural analgesia after cesarean section. Methods：ASAⅠ～Ⅱ 60 patients undergoing cesarean section were all received epidural analgesia and post-operative epidural analgesia.According to different pump speed，patients were randomly divided into three groups with 20 cases each. Group A：0.15％Bupivacaine＋Fentanyl 0.4mg，100ml，pump speed was 2.1ml/h；Group B：0.15％Bupivacaine＋Fentanyl 0.4mg，168ml，pump speed was 3.5ml/h；Group C：0.15％ Bupivacaine＋Fentanyl 0.4mg，40ml pump speed was 5ml/h.The VAS and side effects were recorded at 6h.18h.24h.48h of postoperation. Results：Age Weight Operation time and the numbers of block segments in operation showed no difference in three groups.（P＞0.05） ；At all recorded points of postoperation，the VAS of groupB and groupC were lower than groupA（P＜0.05）：At 24h of postoperation，The numbers of block of segments of groupB and groupC were more than groupA（P＜0.05）；About the side effects in three groups，the? rate of legs numb in group C was higher than groupA and groupB（P＜0.05）. Conclusion：The pump speed can influence the effects of epidural analgesia after cesarean section.The speed was of 3.5ml/h can provide a good analgesia and no legs numb， it is the best c