不同剂量舒芬太尼联合罗哌卡因硬膜外术后镇痛量效研究.docVIP

不同剂量舒芬太尼联合罗哌卡因硬膜外术后镇痛的量效研究 　　【摘 要】 目的：探索舒芬太尼联合罗哌卡因硬膜外术后镇痛时的最佳药物浓度。方法：拟进行重复测量的二因素四水平正交设计，设计罗哌卡因浓度为4水平，分别是0.125%、0.15%、0.175%、0.20%；舒芬太尼浓度为4水平，分别是0.25μg/ml、0.5μg/ml、0.75μg/ml、1.0μg/ml。采取L8（27）正交设计表。结果 0.5μg/ml舒芬太尼联合0.15%罗哌卡因的镇痛效果、改良Bromage分级评分均明显优于其他各组，而舒芬太尼浓度超过0.5μg/ml组尿潴留发生例数多于其他组,罗哌卡因浓度超过0.15%组患者运动神经阻滞程度重于其他组（P0.05）。结论：0.5μg/ml舒芬太尼联合0.15%罗哌卡因是术后镇痛的最佳方案镇痛效果确切，副作用发生率低,适合临床应用推广。 　　【关键词】 舒芬太尼；罗哌卡因；复合；术后镇痛；硬膜外 　　 　　Different doses of sufentanil joint ROM perospirone postoperative analgesia lignocaine 　　epidural the concentration-response research 　　【Abstract】objective to explore sufentanil joint ROM perospirone postoperative analgesia lignocaine epidural the best when drug concentration method of repetitive measure to the two factors four levels orthogonal design, design ROM perospirone for 4 level, lignocaine concentration 0.125% 0.15% 0.175%. 0.20%percent respectively; Sufentanil concentration for four levels, respectively is 0.25 muon g/ml 0.5 muon g/ml 0.75 muon g/ml 1.0 muon g/ml takeL8 (27) orthogonal design table. Results 0.5 muon g/ml of sufentanil joint 0.15% ROM perospirone Bromage lignocaine the analgesic effect of improved scores are much better than other classification, and groups of sufentanil concentration over 0.5 muon g/ml group of urinary retention happened more than the other groups, found Saul lignocaine concentration exceed amisulpiride nerve block 0.15% groups of patients movement is much heavier than other groups (P 0.05) conclusion 0.5 muon g/ml of sufentanil joint 0.15% ROM perospirone postoperative analgesia lignocaine is the best scheme analgesic effect exactly, low rate of side, suitable for clinical application promotion 　　【Key words】sufentanil; ROM perospirone lignocaine; Compound; Postoperative analgesia; epidural 　　 　　临床上经常使用阿片类药联合局麻药来对患者进行术后硬膜外镇痛。罗哌卡因是一种毒性较低的新型长效酰胺类局麻药,在低浓度时运动神经阻滞与感觉神经阻滞明显分离。舒芬太尼作为强效阿片类镇痛药，与μ-受体的亲和力为芬太尼的7~10倍[1]，已用来治疗各种急慢性疼痛 [2]，其常见副作用有恶心呕吐、呼吸抑制、镇静、瘙痒等，有研究表明舒芬太尼用于术后硬膜外镇痛的最佳浓度为0.5μg/ml[3]。适宜浓度的舒芬太尼联合低浓度的罗哌卡因用于