硬膜外注射新克痛宁用于术后镇痛的效果观察

Epidural Administration of New Cobratoxin for Postoperative Analgesia

目的 观察硬膜外腔注入新克痛宁用于术后镇痛的效果。方法 72例胫腓骨骨折病人在连续硬膜外阻滞麻醉下行切开复位内固定术 ,术后随机分为四组 (每组 18例 )向硬膜外腔一次注入容量为 10ml药物 :A组新克痛宁 0 .2 5U/kg ;B组新克痛宁 0 .12 5U/kg加 0 .5 %利多卡因液 10ml;C组吗啡 2mg ;D组吗啡 1mg加 0 .5 %利多卡因液 10ml。按WHO标准 ,术后疼痛程度达Ⅱ级时按组别注药。结果 A组与B组镇痛作用完全 ,镇痛维持时间A组与B组明显延长 ,A组与B组分别为 (4 12± 2 5 )min和 (34 5± 2 8)min ,与C组 [(2 0 7± 2 3)min]和D组 [(16 5± 10 .3)min]比较 ,差异显著(P <0 .0 5 )。注药后 30～ 12 0min患肢足背皮肤温度 ,A组与B组均高于C组与D组 (P <0 .0 5 )。结论 新克痛宁注入硬膜外腔用于术后镇痛 ,维持时间较长 ,镇痛作用完全 。

Objective To investigate the effects of new cobratoxin administered epidurally for postoperative analgesia. Method Seventy-two patients ASA class Ⅰ～Ⅱ undergoing leg orthopedic procedures under epidural block were randomized to four groups (18 patients in each group) 0.25 U/kg new cobratoxin (group A); 0.125 U/kg new cobratoxin with 0.5% Lidocaine 10 ml (group B); 2 mg morphine (group C) and 1 mg morphine with 0.5% Lidocaine 10 ml (group D). When postoperative pain reached to Ⅱ class (WHO) the drugs were injuected to epidural space. Result Time of duration of analgesia was (412±25) and (345±28) min respectively in group A and B, significantly prolonged than group C[(207±23)min]and D[(165± 10.3)min](P<0.05). The temperature of the dorsal skin of the foot increased after 30～120 min(P<0.05). Conclusion new cobratoxin administered epidurally produce prolonged postoperative analgesia without side-effects.