硬膜外病人自控镇痛加入东莨菪碱对尿潴留的预防作用

Prevention of urine retention by scopolamine during patient controlled epidural analgesia

目的观察硬膜外病人自控镇痛(patientcontrolledepiduralaanalgesia,PCEA)药液中加入东莨菪碱对尿潴留的预防作用。方法选择100例择期下肢手术男性病人,随机分为对照组和实验组,每组各50例。对照组(B组)镇痛泵药液配制为芬太尼0.5mg、罗哌卡因125g、恩丹西酮4mg加生理盐水至100mL。实验组(A组)在此基础上加东莨菪碱0.1mg。背景输注(backgroundinfusion,BI)2mL/h,指令剂量(demanddose,DD)4mL,锁定时间(lockoutinterval,LOI)15min。手术后48h拔除镇痛泵及硬膜外导管。采用视觉模糊评分(VAS)评估镇痛效果,记录两组尿潴留发生例数及其他副作用。结果A组尿潴留发生例数及发生率明显低于B组(P<0.01)。镇痛效果和其他副作用的发生率,A组与B组比较差异无显著性(P>0.05)。结论东莨菪碱可以显著减少硬膜外自控镇痛的尿潴留的发生率。

[Objective] To observe the effect of Scopolamine during Patient Controlled Epidural Aanalgesia （PCEA）. [Methods] 100 mail patients who accepted selective lower limb operation were randomly divided into control group （8 group） and experimental group （A group）. 50 patients were distributed into each group. The drugs of group B contained fentanyl 0.5 mg, ropivacaine 125 g, Ondansetron 4 mg and sufficient quantum of normal saline up to 100 mL. In addition to the drugs contained in group B, Scopolamine 0.1 rag was added in group A. Background infusion was seted to 2 ml_/h, Demand dose was seted to 4mL, and Lockout interval to 15 minutes. Epidural catheters were pulled out after about 48 hours. [Results] The incidence rate of group A was significantly lower than that of group B, with the analgesia effection and the other side effects had not changed. [Conclusion] Scopolamine can significantly prevent the urine retention during, patient controlled epidural analgesia （PCEA）.