罗哌卡因与布比卡因对妇科手术后病人自控硬膜外镇痛效果比较

目的 比较下腹部手术后０．２％罗哌卡因（Ｒｏｐ）或０．２％布比卡因（Ｂｕｐ）与吗啡（Ｍｏｒ）配伍病人自控硬膜外镇痛（ＰＣＥＡ）的效应。方法 选择经腹子宫全切术的病人６６例（ＡＳＡⅠ～Ⅱ级），随机分成三组双盲对照观察，Ｒ组（ｎ＝２２）；镇痛药为０．２％Ｒｏｐ＋０．０１％Ｍｏｒ，采用英国Ｇｒａｓｅｂｙ－９３００ＰＣＡ泵，以ＬＣＰ模式给药；Ｂ组（ｎ＝２２）；镇痛药为０．２％Ｂｕｐ＋０．０１％Ｍｏｒ，ＰＣ

Comparison of postoperative analgesic effects between ropivacaine and bupivacaine in patients with patient-controlled epidural analgesia

Objective To compare the analgesic effects of ropivacaine after lower abdominal surgery with bupivacaine in patients with patient-controlled epidural analgesia (PCEA).Methods 66 adult patients undergoing lower abdominal surgery were randomly divided into 3 groups by double-blind: group R with 0 01% morphine and 0 2% ropivacaine, group B with 0 01% morphine and 0 2% bupivacaine and group C with 0 01% morphine and 0 9% normal saline. The mixtures were given with 5 mL loading dose, following by continuous infusion of 0 5 mL/h, 1 mL bolus and lock out time for 10 min.Results Epidural morphine requirement over 24 h and pain scores at rest or with cough reduced significantly in groups R and B than in group C. The demand to delivery ratio (D/D) in groups R and B was lower than that in group C. 64% of patients in group R and 36% in group B had no motor block 2 h after operation. The incidences of nausea and vomiting were between 9% to 13.6% in three groups. Conclusion Conclusion Adding low dose of 0 2% ropivacaine or 0 2% bupivacaine to 0 01% morphine solution during PCEA may greatly enhance the efficacy of postoperative pain relief in lower abdominal surgery. There is no significant motor block in group R.