罗哌卡因联合吗啡或芬太尼镇痛效果与对肠蠕动影响的临床观察

目的探讨罗哌卡因联合不同镇痛药物对手术后肠蠕动恢复情况的影响。方法对105例普外科择期手术患者,ASAⅠ、Ⅱ级,根据不同的镇痛方案随机等分成3组:(1)吗啡组。0.125%罗哌卡因+0.005%吗啡+0.005%氟哌利多。(2)芬太尼组:0.125%罗哌卡因+0.000 5%芬太尼+0.005%氟哌利多。(3)对照组为不实施患者术后自控镇痛。镇痛治疗后4h、8h、12h、24h、36h进行随访,观察疼痛程度、镇静状态、平均动脉压(MAP)、心率(HR)、呼吸频率(RR)、脉搏氧饱和度(SpO_2),并记录肠蠕动恢复时间。结果吗啡组与芬太尼组均取得较好的镇痛效果,VAS评分显著低于对照组(P<0.01);芬太尼组较吗啡组、对照组肠蠕动恢复时间明显缩短(P<0.05)。结论罗哌卡因联合吗啡、芬太尼组患者术后自控镇痛均能获得良好的效果;罗哌卡因与芬太尼联用可缩短肠蠕动的恢复时间。

The analgesic effect of ropivacaine combined with morphine or fentanyl and its effect on enterokinesia

Objective To investigate the effects of patient-controlled epidural analgesic(PCEA)used ropivacaine and different analgesic drugs on recovery of postoperative intestinal peristalsis.Methods 105 patients undergoing selective operation in depart- ment of general surgery(ASA gradeⅠ,Ⅱ)were randomly divided into three groups according to different analgesia projects:mor- phine group(0.125% ropivacaine+0.005% morphine+0.005% droperidol),fentanyl group(0.125% ropivacaine+0.000 5% fentanyl+0.005% droperidol),and co...