布托啡诺复合罗哌卡因在产科硬膜外术后镇痛中应用.docVIP

布托啡诺复合罗哌卡因在产科硬膜外术后镇痛中应用 　　【摘要】 目的 探讨布托啡诺复合罗哌卡因在产科硬膜外术后镇痛（PCEA）中的应用。方法 选择110例腰硬联合麻醉下行剖宫产的产妇，随机分为三组。分别应用0.4μg/ml布托啡诺+0.125% 罗哌卡因（A组，n=35），0.6μg/ml布托啡诺+0.125% 罗哌卡因（B组，n=35），0.8μg/ml布托啡诺+0.125% 罗哌卡因（C组，n=40）。术后行PCEA，即负荷剂量（5ml）+持续剂量（3ml/h）+PCEA剂量（1ml/次）。比较分析术后0～3、3～6、6～12、12～24h各时段切口痛，宫缩痛VAS评分；24h内不良反应发生率：恶心、呕吐、瘙痒、运动阻滞、嗜睡、呼吸抑制。结果 术后PCEA，24h内随布托啡诺浓度增大，切口痛VAS评分和宫缩痛VAS评分降低，其中B组、C组与A组评分有显著性差异（P0.05）。24h内不良反应中恶心、瘙痒的发生率随布托啡诺浓度的增大而增多，其中C组与B组、A组比较有显著性差异（P0.05）。三组的呕吐、运动阻滞、嗜睡无显著差异（P0.05），未发生呼吸抑制。结论 剖宫产术后PCEA，0.6μg/ml布托啡诺复合0.125% 罗哌卡因可取得较好的镇痛效果和较少的副作用。 　　【关键词】 硬膜外镇痛；布托啡诺；剖宫产 　　Application of butrophanol Combined with Ropivacaine for Obstetric Epidural Analgesia in the Cesarean Section Patient 　　Tong De-ming Hu Shu-na 　　The People’ hospital of Tuokexun， Xinjiang Tuokexun， 838100 　　【Abstract】Objective To explore the application of butrophanol combined with ropivacaine for obstetric epidural analgesia in the cesarean section patient controlled epidural analgesia（PCEA）. Methods One hundred and ten cases were randomly divided into three groups with spinal-epidural anesthesia downlink maternal cesarean section i.e. Group A（n=35）， Group B（n=35） and Group C（n=40）. The patients had received 0.4μg/ml Butrophanol combined with 0.125% ropivacaine in Group A， 0.6μg/ml butrophanol combined with 0.125% ropivacaine in Group B and 0.8μg/ml butrophanol combined with 0.125% ropivacaine in Group C， respectively. Postoperative PCEA were performed through loading dose （5ml） + continuous dose （3ml/h） + PCEA dose （1ml/times）. These had been analyzed i.e. the VAS scoring of incision pain，uterine pain in the period of 0～3，3～6，6～12，12～24 h postoperatively； the incidence of adverse reactions such as nausea， vomiting， itching， motor block， drowsiness， respiratory depression in the period of 0～24 h postoperatively. Results The incision pain VAS score and contraction VAS pain score had decreased with butrophanol concentration increasing. The defference between Group B， group C and Group A had statistic si