不同浓度罗哌卡因用于经腹前列腺摘除术后硬膜外镇痛的比较

目的探讨经腹前列腺摘除术后硬膜外镇痛时适宜的罗哌卡因浓度。方法选择择期前列腺摘除术患者90例，在硬膜外麻醉下完成手术。术后接硬膜外镇痛泵。随机分成A组（0．10％罗哌卡因浓度组），B组（0．15％罗哌卡因浓度组）．C组（0．20％罗哌卡因浓度组），每组30例。观察记录术后的血压、SpO2、恶心呕吐、镇痛评分（VAS）、下肢运动阻滞（改良Bromage）评分和膀胱痉挛次数。结果三组的VAS评分无统计学差异（P〉o．05）；不良反应：血压、SpO2、恶心呕吐3组间均无统计学差异；下肢运动阻滞：改良Bromage评分在C组较A组、B组低，有统计学差异（P〈0．05）；膀胱痉挛次数比较：C组无1例发生膀胱痉挛，B组1例发生1次膀胱痉挛，而A组有3例次膀胱痉挛。结论0．15％罗哌卡因浓度对下肢的运动阻滞无明显影响，且可有效解除膀胱痉挛，更适合于经腹前列腺摘除的术后硬膜外镇痛。

Comparison of different concentration ropivacaine in epidural analgesia after transabdominal prostatectomy

Objective To compare ropivaeaine in different concentration for postoperative epidural analgesia in transabdominal prostatectomy. Methods Ninety male patients undergoing transabdomi nal prostatectomy were randomly divided into three groups with 30 in each for postoperative epidural analgesia, Group A：0. 10% ropivicaine-sufentanil; Group B： 0. 15% ropivicaine- sufentanil; Group C：0.20% ropivicaine ＋sufentanil. BP, HR, SpO2, nausea and vomiting, VAS . Bromage score and bladder spasm were recorded after operation. Results BP, HR, SpO2, nausea and vomi ting and VAS were no significant different among three groups; but Bromage score in group C were lower than that in group A and group B; no bladder spasm in group C, but one case in group B and three cases in group A. Conclusion 0. 15% ropivaeaine is the best concentration for patientcontrolled epidural analgesia after transabdominal prostatectomy with lower extremities disfunction and bladder spasm is seldom.