可乐定对左旋布比卡因硬膜外镇痛最低有效浓度的影响

目的探讨可乐定对左旋布比卡因硬膜外镇痛最低有效浓度的影响。方法选择在腰麻与硬膜外联合麻醉下实施子宫切除术的患者120例，随机分成I、Ⅱ、Ⅲ、Ⅳ 4组，每组30例。术毕行左旋布比卡因硬膜外自控镇痛，浓度分别为0．15％、0．125％、0．1％和0．075％，每组均含可乐定2μg／ml。观察记录术后24h内疼痛视觉模拟评分（VAS）、镇痛泵有效按压次数、药物总用量及不良反应。结果Ⅳ组患者术后VAS评分及镇痛泵有效按压次数、药物总用量与其他3组比较差异有统计学意义（P〈O．01），I、Ⅱ、Ⅲ组组间比较差异无统计学意义（P〉0．05）。4组患者不良反应比较差异无统计学意义。结论可乐定复合左旋布比卡因硬膜外镇痛，能增强左旋布比卡因镇痛效果，降低其最低有效浓度。

Effect of clonidine on the minimal effective concentration of levobupivacaine during postoperative epidural analgesia

Objective To observe the effect of clonidine hydrochloride on the minimal effective concentration of levobupivacaine during postoperative epidural analgesia. Methods One hunted and twenty patients with hysterectomy under combined spinal-epidural anesthesia（CSEA） were randomly divided into 4 groups （n=30）. Patient control epidural analgesia （PCEA） was used in groups I , Ⅱ , Ill , IV. The concentration of levobupivacaine was 0.15%, 0. 125%, 0.1%, and 0. 075% respective- ly. Clonidine hydrochloride 2μg/ml was added in all groups. The analgesic effect was observed by means of visual analogue scale （VAS）. The pressing frequency,dosage used, and side effect were re- corded. Results Compared group I , group II and group Ⅲ with group IV the VAS in 4, 8, 16, 24 hour postoperatively, the pressing frequency and the dosage showed significantly difference （P〈 0. 01）. There was no significant difference in side effects in all groups （P〉0.05）. Conclusion Clonidine combined with levobupivacaine in postoperative epidural analgesia can provide a good anal- gesic effect, and decreased the minimal effective concentration of levobupivacaine.