颈胸段硬膜外给药的镇痛效果及对呼吸功能的影响

The Effect of PCA after Cervical-Thoracic Epidural Analgesia and the Influence on Respiratory Function

目的 :观察颈胸段硬膜外注入不同的镇痛药和复合 0 .12 5 %布比卡因的PCA镇痛效果及其对术后通气功能的影响。方法 :在颈胸段硬膜外阻滞下手术 40例经硬膜外给药作术后PCA ,分 4组 ,各组 10例 ,给药总容量为生理盐水 10 0ml,组Ⅰ、Ⅱ、Ⅲ分别含吗啡 5mg、曲马多 5 0 0mg和芬太尼 1mg ,且各复合布比卡因 12 5mg和氟哌利多 5mg。组Ⅳ为对照组 ,不含任何药物 ,为生理盐水。用VAS评定镇痛效果 ,并测定通气功能与SpO2 。结果 :Ⅰ、Ⅱ、Ⅲ组均有较好的镇痛效果 ,吗啡组和曲马多组的效果较芬太尼组更好 ,且有利于术后肺活量恢复 ,所有病例未发生严重的呼吸抑制。

Objective: To compare the effects of different analgetics combined with low concentration local analgestic on PECA and observe the change of respiratory function after PECA. Methods: Forty patients under cervical-thoracic epidural anesthesia were randomly divided into four groups.The total volume given to every patient was normal saline 100ml. GroupⅠreceived morphine (50 μg/ml); groupⅡtramdol (5mg/ml); groupⅢfentanyl (10 μg/ml).All of them combined bupivacaine 125mg and droperidol 5mg.GroupⅣ received normal saline 100ml only. The visual analogue pain scales (VAS), ventilation function and pulse oxygen saturation (SpO2) were measured. Results: Both the group Ⅰ?Ⅱand Ⅲ had good analgesic effect, the effect of morphine and tramdol were better than fentanyl. Conclusion: The better the analgesic effect, the more quickly the recovery of postoperative VC.