观察不同容量罗哌卡因对剖宫产手术术后镇痛的效果

The observation of ropivacain with various volumes on analgesia effect after caesarean section

目的探讨不同容量罗哌卡因对剖宫产手术术后镇痛的效果。方法剖宫产手术患者120例,ASAⅠ～Ⅱ级,随机分为A、B、C、D四组。所有患者均采用腰麻联合硬膜外阻滞,手术结束前10min经硬膜外导管注入负荷量。术毕分别接不同输药速度镇痛泵2ml(A组)、3ml(B组)、4ml(C组)、5ml(D组)。四组患者镇痛泵罗哌卡因浓度均为0.15%,其余药物均相同,镇痛泵总容量分别为100ml、155ml、215ml、275ml。结果四组患者在性别比、年龄、体重、手术时间等方面差异无统计学意义(P>0.05)。与A组比较,C、D组静息、运动VAS评分均明显降低(P<0.05),Bro-mage评分随着注药速度的增加有增高的趋势,但差异无统计学意义(P>0.05)。肛门排气时间随着注药速度的增加逐渐提前,D组较A组明显缩短,满意率增加(P<0.05),但尿潴留四组间差异无统计学意义(P>0.05)。结论5ml/hPCEA泵能够提供满意的镇痛效果,增加胃肠蠕动,肛门排气时间提前,患者满意率增加。

Objective To investigate analgesia effect of ropivacain with various volumes after caesarean section. Methods One hundred and twenty patients , ASA Ⅰ - Ⅱ, undertook caesarean section were dividede into 4 groups randomly. There were 30 patiensts in each group. All operations were made under lumbar anesthesia. A loading dose was infused by catheter about 10 mins before operation completement. As operation completement, a patient - controlled epidural analgesia （PCEA） pump （ A ： 2 ml/h, B：3 ml/h,C：4 ml/h,D：5 ml/h） was fixed. The concentration of ropivacain was O. 15% in each PCEA pump and there was no change in other drugs. The total capacity was as following ：100 ml, 155 ml,215 ml,275 ml. Results Four group patients were no obvious difference in sexuality, age,weight, operation time （ P 〉 0.05 ）. Compared with group A, resting and moving score was decreased significantly in group C and D （ P 〈 0.05 ）. With the increasement of ropivacain volumn, there was a rising trend in Bromage score, but nostatistical significance （ P 〉 0.05 ）. Compared with group A, there was a earlyer anus exhaust time and a higher satisfaction rate in group D（ P 〈 0.05）. Urine retention was observed no change among the four groups. Conclusion The pump （5ml/h） can provide a more satisfactoy analgesia effect and advance gastrointestinal motility.