罗哌卡因复合芬太尼吗啡用于硬膜外自控镇痛泵的疗效观察

目的:探讨腰硬联合麻醉术后硬膜外自控镇痛泵输注罗哌卡因配伍小剂量芬太尼和吗啡用于术后镇痛的疗效和安全性。方法:选择120例腰硬联合麻醉术后镇痛的患者,采用双盲随机法将其分为RFM(罗哌卡因、芬太尼、吗啡)和RM(罗哌卡因、吗啡)两组,每组60例;RFM组用0.15%罗哌卡因+芬太尼0.2mg+吗啡0.5mg配制镇痛液100ml;RM组用0.15%罗哌卡因+吗啡3mg配制镇痛液100ml;两组进行临床观察对比。结果:两组镇痛效果,RFM组有效率96.7%,优良率81.7%,不良反应发生率1.67%;RM组有效率81.7%,优良率60.0%,不良反应发生率18.33%;RFM组镇痛效果明显优于RM组,且不良反应少。结论:罗哌卡因复合芬太尼、吗啡用于腰硬联合麻醉术后硬膜外自控镇痛是一种安全有效的镇痛方法。

Therapeutic Effect of Patient Controlled-Epidural Analgesia by Injecting Ropivacaine Fentanyl and Morphine

Objective To assess the therapeutic effect and safety of patient controlled-epidural analgesia (PCEA) after combined spinal-epidural analgesia by injecting ropivacaine and small dose of fentanyl and morphine. Methods One hundred and twenty patients with combined spinal-epidural analgesia were divided randomly into two groups: group RFM (ropivacaine, fentanyl and morphine) and group RM (ropivacaine and morphine). Each group had 60 cases. 100ml analgesia fluid contained 0.15% ropivacaine, 0.2mg fentanyl, and 0.5mg morphine in group RFM and 0.15% ropivacaine and 3 mg morphine in group RM. The effect and safety were compared between two groups. Results The effects of analgesia were different between two groups. The rate of efficiency, goodness and bad effects were 96.7%、81.7% and 1.67% respectively in group RFM and 81.7%、 60.0% and 18.33% respectively in group RM. Conclusion It's a safety and effective analgesia method by using PCEA after combined spinal-epidural analgesia with ropivacaine, fentanyl and morphine.