芬太尼增强左旋布比卡因硬膜外阻滞效果的临床研究

目的观察和比较不同剂量芬太尼和左旋布比卡因硬膜外麻醉用于骨科下肢手术。方法60例骨科下肢手术患者，ASAI或Ⅱ级，年龄22～60岁。随机分为三组，每组20例。Ⅰ组：为0．75左旋布比卡因10ml＋生理盐水2ml（对照），Ⅱ组：为0．75左旋布比卡因10ml＋芬太尼50μg＋生理盐水至12ml和Ⅲ组：为0．75左旋布比卡因10ml＋芬太尼75μg＋生理盐水至12ml（观察）。结果芬太尼两组分别能够增强硬膜外左旋布比卡因的镇痛效果，同时明显改善患者术中不适反应和提高麻醉质量。50μg和75μg芬太尼组镇痛效果无统计学差异。结论50μg芬太尼可明显增强左旋布比卡因硬膜外麻醉效果，改善术中患者不适和提高麻醉质量，75μg芬太尼未见明显优势。

The clinical observation of fentanyl reinforcement effect of epidural anesthesia with levobupivacaine

Objective The aim of this study was to evaluate the effectiveness of different dosage of fen-tanyl plus levobupivacaine for lower limb surgery. Methods A total of 60 patients who were ASA Ⅰ or Ⅱ, and who were subjected to surgery of lower limbs with epidural anaesthesia were randomised into three groups to re-ceive either 2 ml of saline or 50 or 75 micrograms of fentanyl in 2 ml volume added to 10 ml of 0.75% levobupivaeaine. Results Both doses of fentanyl intensified the epidural anaesthesia and reduced patients dis-comfort during the operation. The lack of motor blockade(MB) as evaluated by the modified Bromage scale was significantly higher in the levobupivacaine plus fentanyl groups than in the levobupivacaine group. Mild pruritus not requiring treatment was more common in fentanyl groups than in the saline group. Conclusion The results suggest that 50 micrograms of fentanyl added to 0. 75% levobupivacaine increases patient comfort and improves the quality of epidural anaesthesia for lower limb surgery, and that adding 75 micrograms does not give further advantage.