罗哌卡因与芬太尼复合昂丹司琼用于小儿硬膜外术后镇痛的临床观察

Analgesic effect of ropivacaine combined with fentanyl and ondansetron on post-operation children

目的 评价0.075%罗哌卡因＋芬太尼2μg/mL＋昂丹司琼15μg/mL用于小儿硬膜外术后镇痛的效果、运动阻滞情况及不良反应。方法 选择ASA（Ⅰ-Ⅱ）级下肢手术患儿30例,在连续硬膜外麻醉下行手术,以0.075%罗哌卡因＋芬太尼2μg/mL＋昂丹司琼15μg/mL进行术后镇痛,给予负荷量2-4 mL,持续背景输注量2-4 mL/h,PCA量为设定值的1/4,全程镇痛72 h,以VAS法评估镇痛效果,Bromage改良法评估下肢运动阻滞程度,观察术后患儿恶心、呕吐、下肢麻木、尿潴留等不良反应。结果 术后镇痛效果优良率达93.3%,无恶心、呕吐、尿潴留、皮肤瘙痒发生,大约在3.5 h左右下肢运动阻滞消失。结论 0.075%罗哌卡因＋芬太尼2μg/mL＋昂丹司琼15μg/mL用于小儿硬膜外术后镇痛安全有效。

Objective To evaluate the effect of analgesic, motoricblock and adverse effects of 0. 075 % ropivacaine combined with fentanyl 2 μg/mL and ondansetron 15 μg/mL on post-operation children, Methods The lower extremity operation was used under epidural, and thirty children were treated with 0.075 96 ropivacaine combined with fentanyl 2 μg/mL and ondansetron 15 μg/mL for postoperative analgesia. The continue infusion dose was 2 - 4 mL/h. After 72 h, the adverse effects, analgesic effects and motoricblock were observed by VAS and Bromage method. Results All of the children gained effective analgesia, and 93.3 96 of them didn＇t have any adverse effects, such as nausea, omitting and urine retention. Leg numbness had last 3 - 5 h or so. Conclusion It is safe and effective to treat patients with 0.075 % ropivacaine combined with fentanyl 2 μg/mL and ondansetron 15 μg/mL.