罗哌卡因用于硬膜外麻醉及术后镇痛的临床观察

Clinical observation of the efficacy and tolerability of ropivacaine in epidural anesthesia and postoperative analgesia

目的 观察罗哌卡因用于硬膜外麻醉及术后镇痛的临床效果.方法 将104例择期下腹部手术患者分为A、B两组：A组为硬膜外组,罗哌卡因硬膜外麻醉,术后镇痛为硬膜外分次注射罗哌卡因,同时加用静脉PCA吗啡;B组为全身麻醉组,接受静吸复合全身麻醉,术后镇痛为单纯静脉PCA吗啡.比较两组的麻醉效果及术后疼痛评分、吗啡用量及不良反应.结果 A组术中镇痛和肌松效果满意,吗啡用量、术后不同时间段内静息和咳嗽时疼痛评分均明显低于B组,差异有统计学意义（P＜0.05）,两组均无严重不良反应.结论 0.2％罗哌卡因在下腹部手术硬膜外麻醉和术后镇痛中临床效果满意,且无严重不良反应,值得临床推广.

Objective To observe the efficacy and tolerability of ropivacaine in anesthesia and postoperative pain management in patients undergoing elective lower abdominal surgery.Methods One hundred and four patients were divided into group A and group B according to different types of anesthesia and post operative analgesia.Patients in group A were given ropivacaine epidural anesthesia,and ropivacaine analgesia multiple epidural injection versus morphine patient-controlled analgesia（PCA） for postoperative analgesia; Patients in group B were given intravenous inhalational anesthesia and morphine patient-controlled analgesia（PCA） for postoperative analgesia.Quality of anesthesia,VAS measurements for postoperative wound pain,morphine consumption and adverse events of the two groups were evaluated.Results The effect of intraoperative analgesia and muscle relaxation was satisfactory in group A,and the morphine consumption,resting and cough pain score in different period were significantly lower than those of group B,the differences were statistically significant（P ＜0.05）.There were no serious adverse reactions in the two groups.Conclusions 0.2％ ropivacaine in anesthesia and postoperative pain management of patients underwent elective lower abdominal surgery.The clinical results are satisfactory,and had no serious adverse reaction,so it is worthy clinical promotion.