可乐定对左旋布比卡因硬膜外镇痛最低有效浓度的影响.docVIP

可乐定对左旋布比卡因硬膜外镇痛最低有效浓度的影响 陈华军，杨海扣，拾翠翠 淮安市妇幼保健院麻醉科 江苏·淮安 223002 【摘要】 目的 探讨可乐定对左旋布比卡因硬膜外镇痛最低有效浓度的影响。方法 选择拟在腰-硬联合麻醉下实施子宫切除患者120例，随机分成Ⅰ、Ⅱ、Ⅲ、Ⅳ组，每组30例，术毕行硬膜外自控镇痛（PCEA）。镇痛药物为左旋布比卡因，浓度分别为0.15%、0.125%、0.1%和0.075%，每组药物中含可乐定2μg/ml。观察记录术后24h内疼痛视觉模拟评分（VAS），镇痛泵有效按压次数及药物总用量。记录下肢运动神经阻滞情况以及不良反应如恶心呕吐、心动过缓、低血压等。结果 Ⅳ组术后4、8、16、24hVAS评分及24h内镇痛泵按压次数，药物总用量与其它3个组比较差异有统计学意义（P＜0.01）, Ⅰ、Ⅱ、Ⅲ组组间比较差异无统计学意义（P＞0.05）。4个组患者不良反应组间比较差异无统计学意义。结论 可乐定复合左旋布比卡因硬膜外镇痛，能增强左旋布比卡因镇痛效果，降低其最低有效浓度。 关键词：可乐定；左旋布比卡因；硬膜外镇痛；有效浓度 The effect of clonidine on the minimal effective concentration of levobupivacaine epidural analgesia CHEN Hua-jun,YANG Hai-kou,SHI Cui-cui. Department of Anesthesiology Health Center for Women and Children, Huaian Jiangsu223002,China [Abstract] Objective To observe the effect of clonidine hydrochloride on the minimal effective concentration of levobupivacaine epidural analgesia. Methods 120 cases exposed to combined spinal- epidural anesthesia (CSEA) on Hysterectomy were randomly divided into 4 groups (n=30): groupⅠ, groupⅡ, group Ⅲ and group Ⅳ.All cases were applied to pump control epidural antalgic (PCEA) after Hysterectomy with levobupivacaine.groupⅠreceiving levobupivacaine 0.15%,groupⅡreceiving 0.125%,group Ⅲ receiving 0.1%,and group Ⅳ receiving 0.075%,all solution contains clonidine hydrochloride 2μg/ml.the antalgic effect of these groups were recorded with visual analogue scale (VAS),the pressing frequency and the doseages,and observe the status of motor nerve block and side effect.Results Compared with groupⅠ,groupⅡand group Ⅲ, group Ⅳshowed significantly difference in VAS of 4,8, 16,24 hour postopertively, the pressing frequency and the doseages (P＜0.01). No difference in side effect was observed among the experimental groups (P＞0.05). Conclusion Applying clonidine combinating levobupivacaine in epidural analgesia has a good antalgic effect ,and can decrease the minimal effective concentration of levobupivacaine. [Keywords] clonidine; levobupivacaine; epidural analgesia; ef