论文部分内容阅读
目的 采用硬膜外病人自控镇痛 (PCEA)技术 ,对 3组不同配伍药液进行研究。方法 15 0例 (ASAⅠ Ⅱ级 )手术病例随机分成 3组。MF组 60例 :吗啡 5 0 μg·h- 1 、芬太尼 4μg·h- 1 ;MD组 60例 :吗啡 5 0 μg·h- 1 、氟哌啶 10 0 μg·h- 1 ;BB组 3 0例 :丁丙喏啡 12 0 μg·h- 1 。 3组药物均以布比卡因 ( 1.5mg·h- 1 )配伍使用。采用双盲法对比观察。结果 给负荷剂量后 ,病人初次按压PCA泵的时间比较 :MD、MF组 >BB组 ( P <0 .0 5 ) ,术后 2 4h 3组病人VAS评分BB组较高 ( P <0 .0 5 )。 2 4h中BB组病人PCA使用次数较多 ,且无效次数也多 ,而MF组和MD组有效次数和无效次数大致相同。提示MF、MD组镇痛效果比BB组好。副作用方面 :恶心、呕吐发生率分别为 15 %、10 %和 3 0 %。 3组病人PCEA期间呼吸、循环无明显变化。结论 吗啡加芬太尼或氟哌啶复合布比卡因镇痛效果确切 ,而丁丙喏啡 ( 12 0 μg·h- 1 ) +布比卡因 ( 1.5mg·h- 1 )镇痛效果欠佳
Objective To study the efficacy and safety of epidural patient-controlled analgesia (PCEA). Methods Fifty cases (ASA Ⅰ Ⅱ) were randomly divided into three groups. 60 cases of MF group: morphine 50 μg · h-1, fentanyl 4 μg · h-1; MD group 60 cases: morphine 50 μg · h-1, haloperidol 10 μg · h- 30 cases: Ding Bing 喏 12 12 0 μg · h-1. All three groups of drugs were treated with bupivacaine (1.5mg · h-1). Using double-blind comparison. Results After the loading dose, the time of initial PCA pump compression was compared in the MD, MF group> BB group (P <0.05), and the VAS score in BB group at 24 h after operation was higher (P <0. 0 5). In 24 hours, patients in BB group used more PCA and had more ineffective times, while those in MF group and MD group were almost the same. Tip MF, MD analgesic effect better than the BB group. Side effects: nausea, vomiting were 15%, 10% and 30%. There were no significant changes in respiration and circulation during PCEA in 3 groups. Conclusions Morphine plus fentanyl or haloperidol combined with bupivacaine has the best analgesic effect, while the analgesic effect of buprenorphine (12 0 μg · h-1) and bupivacaine (1.5 mg · h-1) Poor