盐酸戊乙奎醚联合氟哌利多对曲马多硬膜外术后镇痛不良反应的影响

【目的】观察盐酸戊乙奎醚联合氟哌利多对曲马多用于硬膜外术后镇痛不良反应发生率的影响。【方法】选择行剖宫产术的健康足月孕妇80例，随机分成5组：对照组（C组），单纯曲马多组（T组）、曲马多＋氟哌利多组（TD组）、曲马多＋盐酸戊乙奎醚组（TP组）和曲马多＋盐酸戊乙奎醚＋氟哌利多组（TH组），每组16例。所有病人均在硬膜外利多卡因麻醉下完成手术，C组术毕拔硬膜外导管，其余4组术毕保留硬膜外导管连接自控电子PCA泵。记录术后镇痛效果及术后恶心呕吐（PONV）、皮肤瘙痒、尿潴留、口干等不良反应。【结果】与C组相比，T组、TD组、TP组和TH组可产生明显的镇痛效果，其中TH组明显优于其他三组（P〈0．05）；PONV、皮肤瘙痒等不良反应发病率TH组也明显低于T组、TD组、TP组（P〈0．05）。【结论】盐酸戊乙奎醚联合氟哌利多可明显降低曲马多用于硬膜外术后镇痛不良反应的发病率。

Effect of Penehyclidine Hydrochloride Combined with Droperidol on Postoperative Side Reactions During Epidural Analgesia with Tramadol

[Objective]To study the effect of penehyclidine hydrochloride combined with droperidol on the side reactions of tramadol postoperative epidural analgesia. [Methods] Eighty ASA class Ⅰ or Ⅱ patients undergoing anesthesia after caesarean section were divided randomly into five groups with 16 cases for each. No injection drug was given in control group. Single bolus of tramadol 20mg in normal saline was given in group T. Single bolus of tramadol 20mg and droperidol 2mg in normal saline was given in .group TD. Single bolus of tramadol 20mg and penehyclidine hydrochloride lmg in normal saline was administrated in group TP. Single bolus of tramadol 20mg, penehyclidine hydrochloride lmg and droperidol 2mg in normal saline was administrated in group TH. All drugs were injected into epidural space within 5 min after operation. Analgesic efficacy and side effects were observed and recorded during postoperative analgesia. [Results] Compared with group C, group T, TD, TP and TH could pro- duce clear analgesic effect, in which group TH was significantly better than that in group T, TD and TP （ P〈0. 05）. Side effects such as postoperative nausea and omitting, skin pruritus, urinary retention and so on were significantly less in group TH than those in group T, TD and TP （ P 〈0.05）. [Conclusion] Penehyclidine hydrochloride combined with droperidol can significantly reduce the incidence of postoperative side effects during epidural analgesia with tramadol.