布托啡诺复合罗哌卡因用于剖宫产术后硬膜外镇痛的研究

目的观察布托啡诺复合罗哌卡因用于剖宫产术后硬膜外镇痛效果。方法40例(ASAI～Ⅱ级)剖宫产病人随机分成两组,每组各20例。吗啡组(M组):镇痛液0.2%罗哌卡因+0.004%吗啡;布托啡诺组(B组):0.2%罗哌卡因+0.004%布托啡诺。采用负荷量+持续剂量给药模式,持续剂量背景流速2ml/h。结果布托啡诺组除8h点VAS评分明显高于吗啡组,BCS评分明显低于吗啡组外(p<0.01),其余各时间点无显著性差异。两组病人术后各时间点Ramesay评分无显著性差异(p>0.05)。但吗啡组恶心呕吐和皮肤搔痒发生率明显高于布托啡诺(χ2分别为4.800和8.533)(p<0.05和p<0.01)。结论0.2%罗哌卡因+0.004%布托啡诺能取得与0.2%罗哌卡因+0.004%吗啡相似的镇痛效果,但能显著减轻不良反应。

Objective To observe the analgesic effects with butorphanol plus ropivacaine for postoperative epidural analgesia after caesarean section. Methods Forty primiparae （ASA Ⅰ～Ⅱ ） schedualed for elective of caesarean section were divided into two groups with 20 cases each. Morphine group （group M） received the mixture of 0.2% ropivacaine and 0.004% morphine; Butorphanol group （group B） received the mixture of 0.2% ropivacaine and 0.004% butorphanol, butorphanol）. The two groups were carried out by loading-continuous administration with continuous doses of 2 ml/h by a pump. Results VAS in group B was higher than that in group M at 8h during postoperative （p〈0.01）, BCS in group B were lower than that in group M at 8 h during postoperative （p〈0.01）. There was no significant difference among the two groups in the Ramesay score （p〉0.05）. The incidence of nausea, Vomit and pruritus in group M was higher than that in group B （x2 respectively is 4.800 and 8.533） （p〈0.05 or p〈0.01）. Conclusion The efect of epidural butorphanol plus ropivacaine for postoperative analgesia is very good, and the incidences of nausea, Vomit and pruritus keep in little.