罗哌卡因与利多卡因术后硬膜外自控镇痛的比较

Study on the efficacy and safety of ropivacaine compared with lidocain for patient control extradural analgesia

目的:观察低浓度罗哌卡因与利多卡因行硬膜外自控镇痛的效果。方法:选择ASAⅠ￣Ⅱ级外科中下腹部手术病人60例,随机分为罗哌卡因组(R组)和利多卡因组(L组),选硬膜外麻醉进行手术,手术后使用一次性微量止痛泵行病人自控镇痛(PCEA)。R组:0.2%罗哌卡因,L组:0.5%利多卡因,泵中均加入度冷丁200mg,芬太尼0.3mg,输注速度2ml/h,在镇痛效果差时推注罗哌卡因5ml(未稀释)。分别于镇痛开始后4小时、8小时、12小时、24小时观察并记录镇痛效果及不良反应。结果:两组病人镇痛各时间段VAS评分平均R组为(2.1±0.3)分、L组为(3.8±0.5)分,不良反应无显著性差异。结论:两种方法均可满足病人术后镇痛需要,但罗哌卡因优于利多卡因。

Objective：To observe the efficacy and safety of using low-concentration ropivaine arid lidocain for patient control extradural analgesia（PCEA）.Methods：60 ASA Ⅰ - Ⅱ degree patients of middle-lower abdominal surgery were enrolled in this study.The patients were randomized to receive 0.2% ropivacainc（study group,n=30）or 0.5% lidoeain （control group,n=30）.And were using mierodosage anodyne for PCEA, Basal drugs were dolantin 20mg and fcntanyl 0.3mg in two groups.The analgesie effects and adverse drug reactions （ADR）after analgia 4h,8h, 12h and 24h were observed and reeorded.Results：VAS assessment in two groups was 2.1±0.3 anti 3.8±0.5 respectively, ADR was similar between the two groups.Conclusion：Ropieacaine and lidocain were effective drugs in treating post-operative pain, and ropivaeaine was better than lidoeain.