芬太尼复合新斯的明用于硬膜外术后镇痛对肠蠕动的影响

目的观察芬太尼复合新斯的明用于上腹部手术后硬膜外腔镇痛(PCEA)对肠蠕动的影响。方法选择90例上腹部手术患者,随机分为3组,每组各30例,各组配方分别为0.1%罗哌卡因 0.001%芬太尼 新斯的明1mg 氟哌利多2.5mg 0.9%生理盐水共100ml、0.1%罗哌卡因 0.001%芬太尼 氟哌利多2.5mg 0.9%生理盐水共100ml和0.1%罗哌卡因 吗啡5mg 氟哌利多2.5mg 0.9%生理盐水共100ml。手术结束后均按各组配方开始PCEA,背景流量2ml/h,自控量0.5毫升,锁定时间15分钟。分别纪录4、8、12、24、36和48h镇痛效果及首次肛门排气时间。结果3组术后按视觉模拟评分法(VAS)评分,术后镇痛效果差异无统计学意义,首次肛门排气时间差异有统计学意义(P<0.05)。结论芬太尼复合新斯的明应用于上腹部手术后镇痛可以加速胃肠蠕动的恢复,有利于手术后患者的康复。

Effects of neostigmine combined with fentanyl on enterokinesia in patient controlled epidural analgesia after upper abdominal surgery

Objective To investigate the effect of neostigmine combined with fentanyl on enterokinesia in patient controlled epidural analgesia (PCEA)after upper abdominal surgery. Methods Ninety adult patients undergoing upper abdominal operation were randomly assigned to three equal groups. The drug formula used in each group was 0.1% ropivacaine 0.001% fentanyl neostigmine 1mg droperidol 2.5mg, 0.1% ropivacaine 0.001% fentanyl droperidol 2.5mg, and 0.1% ropivacaine morphine 5mg droperidol 2.5mg, respectively. The drugs were injected after surgery, in which the background infusion rate, bolus and lockout time were 2 ml/h, 0.5 ml and 15 min respectively. The efficacy of postoperative analgesia and the time of the first passing flatus in each group were recorded at 4h, 8h, 12h, 24h, 36h, and 48h postoperatively. Results According to visual analogue scales, the efficacy of postoperative analgesia in each group showed no statistical difference. The time of the first passing flatus differed evidently (P<0.05). Conclusion Patient controlled epidural analgesia with neostigmine and fentanyl after upper abdominal surgery can accelerate recovery of intestinal peristalsis.