新斯的明复合耐乐品术后PCEA剂量的研究

The Research of Dose of Neostigmine Combined with Norpivacaine in PCEA after Cesarean Section

目的观察新斯的明复合耐乐品剖宫产术后 PCEA 剂量效应及相关副作用,以期寻找一个合理的镇痛配方。方法 36例择期行剖宫产病人,采用随机双盲设计分为三组,分别用新斯的明2mg、3mg 或吗啡4mg 加耐乐品150mg,稀释到100ml,用一次性自控输液泵行自控硬膜外镇痛。观察术后6h、12h、24h、48h 的 VAS 评分,血压、心率变化及胃肠功能恢复时间和相关副作用。结果术后24h 内新斯的明3mg 组的 VAS 评分与吗啡4mg 组无显著性差别,新斯的明2mg 组24h 的 VAS评分比吗啡4mg 组的高。吗啡全身瘙痒发生率约为41.7%。三组胃肠功能恢复时间无显著性差别。术后血压和心率与术前比较均无显著性差别。结论新斯的明3mg 加耐乐品150mg PCEA 中的镇痛效应相当于吗啡4mg 加耐乐品150mg,而无吗啡的全身瘙痒副作用,可作为 PCEA 的一个较好的配方。

Objective To investigate the dose - effect and side - effects of Neostigmine combined with Norpivacaine after Cesarean section in PCEA. Methods 36 eases of CESS were doubleblind divided into 3 groups randomly, and neostigmine 2mg, 3mg or Morphine 4mg combined with Norpivacaine 150mg was disolated to 100ml with N.S.respectively. The VAS、HR、BP side - effects and the gastrointestinal function recover time were recorded after 6h、12h、24h、48h after operation. Results The VAS of Neostigmine 3mg group wasn＇t significantly different compared with Morphine 4mg group within 24h after operation. And the VAS of Neostigmine 2mg group was significantly different compared with Morphine 4mg group. The rate of isching was 41.7% in Morphine group. The recover time of gastrointestinal function wasn＇t significantly different in the three groups. The post - operation HR, BP were not significantly different compared with pre operation. Conclusion The analgesia effect of Neostigmine 3mg combined Norpivacaine 150mg had no significantly difference compared with Morphine 4mg combined with the same dose Norpivacaine in PCEA after CESS, but no side - effect wasn＇t found in Neoustgimine groups, So it can be a better therapy of PCEA.