0.1%罗比卡因与0.1%布比卡因持续硬膜外给药用于高龄病人TURP术后镇痛的研究

Postoperative analgesia with extraepidural administration of 0.1% ropivacaine or 0.1% bupivacaine in advancedage patients underwent TURP

目的比较0.1%罗比卡因与0.1%布比卡因复合芬太尼持续硬膜外给药用于高龄病人前列腺手术后镇痛的效果及对呼吸循环功能的影响。方法20例ASAⅡ～Ⅲ级,年龄80～91岁,择期行经尿道前列腺摘除(TURP)的病人,随机均分为0.1%罗比卡因组(A组)和0.1%布比卡因组(B组)。于手术结束前经硬膜外导管2ml/h分别持续注入0.1%罗比卡因和0.1%布比卡因,同时辅助2μg/ml芬太尼,测定术后4、8、12、24hVAS,镇静评分,记录BP、HR、SpO2及不良反应。结果两组的镇痛效果相当,BP、HR、SpO2等生理指标差异无显著意义,均无呼吸抑制及恶心、呕吐发生。结论0.1%罗比卡因与0.1%布比卡因持续硬膜外给药用于高龄病人TURP术后镇痛效果相似,对呼吸循环影响相似。

Objective To compare the effects of intraepidural administration of 0.1% ropivacaine or bupivacaine on the postoperative pain and the function of respiration and circulation in advanced age patients underwent TURP. Methods Twenty 80-91 years old patients, ASA Ⅰ-Ⅱ , underwent selective TURP were randomly assigned into two groups. The patients in group A received 0.1% ropivacaine given by infusion pump after operation,those in group B were given 0.1% bupivacaine . The infusion velocity of pump was 2 ml/h, the fentanyl concentration in the analgesia liquid was 2 μg/ml. The evaluation of VAS, BP, HR, SpO2 and other complications was made at 4,8,12 and 24 h after operation. Results The analgesia effect of group A was similar to that of group B, and there were no significant differences in the value of BP, HR,SpO2 between two groups. Conclusion Both 0.1% bupivacaine and 0.1% ropivacaine can be safely and effectively used to control postoperative pain without adverse effect on circulation and respiration in advanced age patients underwent selective TURP .