比较不同药物硬膜外镇痛对家兔胃肠运动的影响

Effect of ttumadol ropivcanie morphine on gastrointestinal motility in postoperative epidural analgesia in rabbit

目的比较曲马多、罗哌卡因、吗啡三组药物用于硬膜外术后镇痛效果及对家兔胃肠运动功能的影响,探讨胃动素(MOT)、血管活性肠肽(VIP)血浆浓度与家兔胃肠运动功能的关系。方法健康家兔、性别不限、体重无差异(P>0.05),喂少纤维饲料3天,清水1天。随机分为四组,其中生理盐水7只(N组),曲马多组(T组)、罗哌卡因组(R组)、吗啡组(M组)各为8只,经胃管注入美蓝2ml,静脉注射3%戊巴比妥钠1ml/kg,静脉采血2ml。硬膜外穿刺置管接硬膜外镇痛泵(2ml/h)。术后1小时、4小时分别采血2ml。处死家兔,分离小肠。检测镇痛评分、美蓝运动速率及不同时点的胃动素(MOT)、血管活性肠肽(VIP)。结果N组疼痛评分均数与其他三组均有显著差异(P<0.05),其余三组镇痛效果比较无显著意义(P>0.05);四组美蓝运动速率均数比较差异有显著意义(P<0.05),其中R组美蓝运动速率最快,与M组和N组比较均有显著差异(P<0.05),T组较M组比较有显著差异;各组组内MOT均数比较无显著意义(P>0.05);各组各时点VIP测定值比较差异无显著意义(P>0.05)。结论曲马多、罗哌卡因及吗啡镇痛效果较好,曲马多,罗哌卡因对胃肠运动功能影响较小;家兔血清MOT、VIP浓度与硬膜外术后镇痛胃肠运动功能无相关性。

Objective To investigate the effects of trumadol, ropivacine and morphine on gastrointestinal motility in postoperative epidural analgesia in rabbit; To discuss the relativity between motilin （MOT）, vasoactive intestinal peptide （VIP） and gastrointestinal motility. Methods Thirty - one rabbits were randomly divided into 4 groups, the range of epidural puncture point is at L3 - L4 ; group S （7 rabbits, average weigh approximately 1.51 kg） received PCEA with 0.9% saline 50 ml ; group T （ 8 rabbits, average weigh approximately 1.58 kg） with 0.2% trumadol ; group R （ 8 rabbits, average weigh approximately 1.53 kg） with 0. 125% ropivocaine; group M （8 rabbits, average weigh approximately 1.58kg） with 0. 005% morphine. In four groups, the rate of background infusion was 2 ml · h ^-1. Infusion Methylene Blue 2 ml from the gastric tube , after 4 hour the length of Blue intestine , （D） and the whole length of small intestine （L） had been measured. The rate of Methylene Blue motion （D/L） had been calcaulated; To mensurate the concentration of MOT and VIP at preoperation, 1 h and 4 h after PCEA. Results The analgesia was satisfactory in group T, group R and group M than in group S（ P 〈 0.05 ） ; The rate of Methylene Blue motion in group T and group R was higher than group S and group M（ P 〈 0.05 ）. There was no significant difference in plasma concentration of MOT, VIP in four groups （ P 〉 0.05 ）. Conclusion Effect of trumadol, ropavacaine on gastrointestinal motility was smaller than morphine in postoperative epidural analgesia. There is no significant relativity between MOT, VIP and the rate Meth- ylene Blue motion in rabbit.