布比卡因、芬太尼伍用氟哌利多或咪唑安定用于术后硬膜外镇痛

Patient-controlled epidural analgesia(PCEA)with bupivacaine and fentanyl combined with droperidol or midazolum

目的 :观察布比卡因、芬太尼伍用氟哌利多或咪唑安定术后硬膜外镇痛 (PCEA)的临床疗效。方法 :选择 60例ASAⅠ -Ⅱ级胸、腹部及下肢手术病人 ,PCEA用药随机分为 3组 ,每组 2 0例 :A组 (为对照组 ) 0 .75 %布比卡因 15 0mg、芬太尼 0 .4mg ;B组0 .75 %布比卡因 15 0mg、芬太尼 0 .4mg、氟哌利多 5mg ;C组 0 .75 %布比卡因 15 0mg、芬太尼 0 .4mg、咪唑安定 5mg。均加 0 .9%氯化钠至 10 0ml,持续给药注速 2ml·h-1,单次PCA剂量 0 .5ml,锁定时间 15min。采用视觉模拟疼痛评分 (VAS)和镇静评分。结果 :3组病人VAS <3 .5分 ,组间比较无显著性意义 (P >0 .0 5 )。镇静评分 :B组明显高于A组 (P <0 .0 5 ) ,C组也高于A组 (P>0 .0 5 )。镇痛总体满意度B组 >C组 >A组。术后恶心呕吐的发生率以A组为高 ,B组发生尿潴留 2例。结论 :布比卡因、芬太尼、氟哌利多或咪唑安定配伍行术后PCEA ,镇痛安全有效 。

Objective:To investigate the efficacy of patient -controlled epidural analgesia(PCEA) with bupivacaine and fentanyl combined with droperidol or midazolum.Methods:Sixty patients underwent thoracic, abdomen and lower limbs operation were randomly divided into three groups(n=20),group A(control group): 0.75% bupivacaine 150 mg, fentanyl 0.4 mg; group B: 0.75% bupivacaine 150 mg,fentanyl 0.4 mg, droperidol 5 mg;group C: 0.75% bupivacaine 150 mg,fentanyl 0.4 mg, midazolum 5 mg,all added to 100 ml of 0.9% NaCl.Background infusion 2 ml·h -1,bolus 0.5 ml,lockout time 15 min.Results:All three groups showed lower VAS score (<3.5), the sedation score was significantly higher in group B than that in group A(P<0.05), the incidence of nausea and vomiting were higher in group A than those in group B and C.Conclusion:PCEA with bupivacaine and fentanyl combined with droperidol or midazolum provides an excellent analgesic effect.