不同浓度丁丙诺啡术后硬膜外病人自控镇痛的临床研究

The Clinical Study on autocontrol analgesia of different concentration Buprenorphine in the patientsafter extradural operation

目的 探讨 L CP模式丁丙诺啡的最低有效止痛浓度。方法 选择硬膜外麻醉效果优的手术病人 180例 ,随机分为六组 ,以 0 .2 %布比卡因 10 0 m l+5 m g氟哌利多为基础液 ,除第 组单纯用 0 .2 %布比卡因外 ,其余加麻醉性镇痛药 , ～ 组丁丙诺啡分别为 0 .1mg、0 .15 mg、0 .2 2 5 mg、0 .3m g, 组为吗啡 5 mg。对比其 48小时用药量、手控次数、镇痛效果、副作用。结果 用药量和手控次数 ～ 组无差异 (P >0 .0 5 ) ,与 组相比有显著差异 (P <0 .0 5 )、与 组相比差异非常显著 (P <0 .0 1) ;镇痛优良率 ～ 组无差异 ,与 、 组相比差异非常显著 (分别为 P <0 .0 1、P <0 .0 0 5 )。不良反应 、 、 组明显低于 、 组 (P <0 .0 0 5 ) , 组与 组相比亦有显著差异 (P <0 .0 5 )。结论 在相同条件下吗啡的不良反应明显高于丁丙诺啡 ;在上述基础液的条件下 ,丁丙诺啡的有效止痛浓度以 0 .0 0 0 2

Objective Exploring the lowest available analgesia concentration of Buprenorphine in the L CP m odel.Meth- ods 180 operated patients whose epidural anesthesia were successful,were separated into6 groups random ly.Except the group was only use of0 .2 % Bupivacaine,the to groups were use of basic liquid adding anesthetic analgetic Buprenorphine 0 .1mg、0 .15 mg、0 .2 2 5 mg0、0 .3mg and 5 mg respectively.The basic liquid contains0 .2 % Buivacaine10 0 m l and Droperidol 5 mg.Com pare each group's m edicine dosage in48hours、hand control tim es,analgesia efficacy and side effect respectively.Re- sult There are no significant difference between the m edicine dosage and hand control times in the to groups(P >0 .0 5 ) ,but have obvious difference com pared with group(P <0 .0 5 ) and have very obvious difference com pared with group( P <0 .0 1) .There are no significant difference in analgesia effects among ～ groups,but have obvious difference compared with ～ groups(P <0 .0 1andp <0 .0 5 respectively) .The side effects of 、 and groups are lower than those of and groups(P <0 .0 5 ) ,and italso has statistical significance in comparison with and groups(P <0 .0 5 ) .Conclusion The side effects of Morphine are higher than those of Buprenorphine under the same conditions.The available analgesia con- centration of Buprenorphine is about0 .0 0 0 2 % suitable under above basic liquid condition.