剖胸术后硬膜外持续输注布比卡因和芬太尼镇痛

ANALGESIC EFFECTS OF CONTINUOS EPIDURAL INFUSING OF BUPIVACAINE AND FENTANYL MIXTURE AFTER THORACOTOMY

４０例剖胸病人分两组，Ⅰ组于术后采用硬膜外连续输注布比卡因和芬太尼复合液，Ⅱ组于术后硬膜外推注吗啡，比较两组的镇痛、镇静效果，以及镇痛前后的Ｂｐ、ＨＲ、Ｒ、ＶＣ、ＴＶ、ＳｐＯ２变化和副作用。结果示：Ⅰ组比Ⅱ组镇痛作用起效快，咳嗽ＶＲＳ评分高，ＶＣ增加更显著，术后增快的呼吸减慢较明显，恶心、呕吐发生率Ⅰ组为８％，Ⅱ组为２６．７％。Ⅰ组无尿潴留，Ⅱ组尿潴留发生率为５３，３％。

orty cases of thoracotomy were divided into two groups. Mixture bupivacaine and fentanylwas used for continuous epidural infusion in group l after thoracotomy. Morphine was injected in-to the epidural space for the patients of group II. The analgesic, sedative and side effects and thechanges of Bp、HR、R、VC、 TV, SpO2 before and after analgesia of both groups were compared.The results showed that the analgesia effects in group l were quicker than those in group II,thecoughing VRS significantly higher(P<0. 0l),VC markedly increased(P<0. 05)and the respira-tion frequency obviousiy slower and the neusea and vomitting rate was 8 per cent in roup l and26.7 per cent in group II.There was no urine retention in group l and the incidence in group II 53.3 per cent.