罗哌卡因复合布托啡诺用于剖宫产术后硬膜外镇痛的临床研究

The Efficacy of Ropivacaine Combined with Butorphanol on Patient with Postoperative Controlled Epidural Analgesia

目的:评价罗哌卡因复合布托啡诺用于剖宫产术后硬膜外镇痛的临床效果及不良反应,确定其用于硬膜外镇痛的有效性、可行性。方法:选择ASAⅠ-Ⅱ级剖宫产病人100例,随机分成2组:布托啡诺组(B组),吗啡组(M组)。镇痛药物分别为:B组(n=50)0.2%罗哌卡因+0.004%布托啡诺;M组(n=50)0.2%罗哌卡因+0.004%吗啡。采用负荷量+持续流量的给药方式,流速为2mL/h。双盲观察比较两组镇痛度、镇静度、舒适度以及恶心呕吐、搔痒、呼吸抑制情况。结果:镇痛度:通过VAS评分,B组、M组镇痛度无显著差异性(P>0.05);镇静度:通过Ramesay评级,B组高于M组(P<0.05),有显著差异性;舒适度:B组、M组无显著差异性;并发症:B组恶心呕吐及皮肤搔痒的发生率低于M组。结论:罗哌卡因复合布托啡诺用于剖宫产术后硬膜外镇痛的效果确切,不良反应低于罗哌卡因复合吗啡。

Objective： To evaluate the analgesic effects and complication of ropivacaine in combined with butorphanol in postoperative epidural analgesia after cesarean section,to determine their effectiveness and feasibility for epidural analgesia.Method：100 cases were randomly divided into 2 groups.Group B（n=50） mixture 0.2% ropivacaine and 0.004% butorphanol;Group M（n=50） mixture 0.2% ropivacaine and 0.004% morphine.All the cases were loading-continuous model with continuous dose 2mL/h.Then observed and contrasted the results of VAS,results of Ramesay,comfort and complication between the two groups.Result： There＇s no difference of analgesia VAS between group B and group M.The results of ramesay for group B are higher than group M.There＇s no difference of the degree of comfort（BCS） between group B and group M.The incidence of nausea and vomiting,pruritus in group M is higher than in group B.Conclusion： Ropivacaine combined with butorphanol provides effective post-cesarean section analgesia and has less adverse effects.