高乌甲素、吗啡配伍罗哌卡因术后镇痛对肠功能恢复及血浆胃动素水平的影响

目的:比较高乌甲素与吗啡分别配伍罗哌卡因用于术后硬膜外镇痛对术后患者肠功能恢复及血浆胃动素水平的影响。方法:选择45例择期行胃癌根治术患者,随机分为3组:高乌甲素罗哌卡因组(L组,15例);吗啡罗哌卡因组(M组,15例);对照组(P组,15例),哌替啶肌注组。测定术毕即刻、术毕6h、24h及48h血浆胃动素含量,同时记录术后48h内恶心呕吐程度、频率及肛门首次排气时间。结果:M组术毕24h胃动素水平明显高于其他两组(P<0.05),且术后恶心呕吐发生的程度及发生率明显高于其他组(P<0.05)。L组与P组比较无明显差别(P>0.05)。L组肛门排气时间明显短于P组和M组(P<0.05)。结论:高乌甲素配伍罗哌卡因用于术后镇痛,患者恶心、呕吐发生率低,且不影响胃肠道功能的恢复,值得推广。

Effects of lappaconitine, morphine combined with ropivacaine for postoperative analgesia on the plasma motilin level and gastrointestinal function

Objective: To compare the effects of lappaconitine and morphine combined with ropivacaine for postoperative analgesia on the recovery of intestinal function and the concentration of plasma molitin.Methods: 45 patients undergoing selective radical operation for carcinoma of stomach were randomly divided into 3 groups: group L(lappaconitine combined with ropivacaine,n=15),group M(morphine combined with ropivacaine,n=15) and group P(pethidine,n=15).The concentrations of plasma molitin were measured at the end of operation,6h,24h and 48h postoperation.The extent and frequency of PONV and the time of anal exhaust were also recorded.Results:The conceration of plasma molitin of group M at 24h postoperation was significantly higher than the other two groups(P<0.05),the PONV was more severe and more freguent in group M than in the other two groups(P<0.05).The time of anal exhaust of group L was shorter than that of group M and group P.Conclusion: Lappaconitine combined with ropivacaine was suitable for analgesia after gastrointestinal operation.