丁卡因用于硬膜外术后镇痛的临床观察

目的观察0.1%丁卡因加曲马多、地塞米松用于硬膜外麻醉术后镇痛的效果和不良反应。方法选择美国麻醉医师协会对手术、麻醉的安危评定标准(ASA)I~II级择期手术患者300例,按硬膜外穿刺间隙低、中、高部位分为L、M、H三组,每组100例。以0.1%丁卡因100 ml加曲马多6 mg/ml、地塞米松10 mg进行术后硬膜外持续泵注镇痛(2ml/h)。观察术后48 h内镇痛效果:以视觉模拟评分法(VAS)和患者自评镇痛效果满意度评估镇痛效果。观察术后2 d内患者恶心、呕吐、下肢麻木、头痛、皮肤瘙痒等不良反应。结果三组术后镇痛效果满意,不良反应:恶心、呕吐每组1例,L组有2例出现单侧下肢麻木。结论0.1%丁卡因加曲马多、地塞米松用于硬膜外术后镇痛,镇痛效果良好、安全,不良反应小。

Dicaline in Postoperative Epidural Analgesia

Objective To explore the effect and adverse effect of using 0.1% dicaine with tramadol and dexamethasone in postoperative epidural analgesia.Method 300 cases of the safety and danger evaluation standards of operation and aesthesia established by American Society of Anesthesia(ASA)1-2 grades were divided into Low(L),Middle(M),High(H) groups according to epidural puncture space.There was 100 cases in each group.0.1% dicaine(100ml)with tramadol(6mg/ml) and dexame thasone(10mg)were used by continual pump infusion(2ml/h) in postoperative epidural analgesia.The analgesic effect within 48 hours after operation were observed.The two evaluation methods were visual analogue score(VAS) and satisfaction degree of patient self-assessment.The adverse effects including nausea、vomiting、lower limb numbness、headache and pruritus within two days after operation were observed.Results There were satisfactory effects in all groups.The adverse effect of nausea and vomiting occurred in every group with one patient.Two patients appeared half lower limb numbness in L group.Conclusion The use of 0.1% dicaine with tramadol and dexamethasone in postoperative epidural analgesia is safe and effective.The adverse effcct is little.