曲马多复合罗哌卡因硬膜外阻滞用于剖宫产术.docVIP

曲马多复合罗哌卡因硬膜外阻滞用于剖宫产术张胜，吴新文，朱和生，邓庆华，刘崇丽，辛博 文章编号：1008-6919（2006）08-0082-02 中图分类号:R614.4+2 文献标识码：A 【摘要】 目的：观察曲马多复合0.75?罗哌卡因硬膜外阻滞用于剖宫产术的麻醉效果。方法 36例20～40岁， ASAⅠ～Ⅱ级，行剖宫产术病人，根据硬膜外阻滞用药不同随机分成，Ⅰ组：曲马多复合罗哌卡因组（n =18），Ⅱ组：罗哌卡因组（n =18）。观察BP、HR、SpO2、感觉阻滞（针刺法）、下肢运动阻滞（Bromage评级）、术中镇痛效果、腹壁肌松质量、新生儿即刻Apgar评分及不良反应。 结果 Ⅰ组感觉阻滞起效时间短于Ⅱ组，而作用持续时间及术后VAS＜4分时间长于Ⅱ组（P ＜0.05）；术中探查、取胎时点镇痛效果评价为优的比率Ⅰ组高于Ⅱ组（P ＜0．05），其它时点差异无显著性。 结论 用于剖宫产术，复合曲马多可改善0.75?罗哌卡因硬膜外阻滞的镇痛效果：提高术中镇痛质量，缩短起效时间，延长维持时间。 关键词：曲马多；罗哌卡因；硬膜外阻滞；剖宫产术 Efficacy of tramadol addition to ropivacaine epidural anaesthesia for caesarean section [Abstract]ObjectiveTo investigate efficacy of tramadol addition to ropivacaine 0.75% epidural anaesthesia for Caesarean section． MethodThirty-six ASA I and II patients for caesarean section undergoing epidural anaesthesia were randomly assigned to receive an dose of ropivacaine 0.75% (100mg) plus 50 mg of tramadol (group I，n = 18)，or ropivacaine0.75% (100mg) (group II，n = 18)．Maternal vital signs (BP，HR，SpO2) were monitored．Epidura cather was placed at L2-3 and a test dose of 4 ml was given．5min later when no signs of subarachnoid injection was evident , another 9.3 ml was given．Before surgery，if necessary，additional epidural ropivacaine was injected．Onset time of sensory blockade was time to achieve sensory block at T10. The quality of intraoperative analgesia and abdominal wall relaxation，degree of motor block (modified Bromage scale) and side-effects were assessed．neonate were evaluated after delivery by Apger scores． Postoperative pain was assessed using the visual analog scale (VAS)，duration of complete analgesia was defined as the time from the end of the last injection to VAS score ＞ 0，duration of effective analgesia was defined as the time to VAS score ＞ or = 4． ResultOnset time of sensory blockade was significantly shorter in the group I than those in group?(P?0.0 5) .Duration of complete analgesia and duration of effective analgesia were longer in the group I than those in group