丁卡因与布比卡因分别联合芬太尼及氟哌利多在硬膜外术后镇痛中的效果观察

目的探讨丁卡因联合布比卡因与芬太尼及氟哌利多在硬膜外术后镇痛（PCEA）的临床效果。方法将80例行硬膜外手术患者随机分为试验组（丁卡因组,其药物组成成分：1%丁卡因12.5 mL、0.7 mg芬太尼、5 mg氟哌利多）和对照组（布比卡因组和其药物组成成分：0.75%布比卡因16.7 mL、5 mg氟哌利多、0.7 mg芬太尼）。两组自控硬膜外镇痛（PCEA）,两组总容量为100 mg,持续计量为2 mL/h,每15分钟为一次锁定时间,每1小时最大输出量2 mL,在术后72 h内停止镇痛。记录术后6 h、24 h镇痛效果、镇静评分、副作用（尿潴留、恶心、呕吐、眩晕）、下肢运动阻滞程度。结果两组镇痛效果和镇静评分差异无统计学意义（P〉0.05）。两组的双下肢运动阻滞程度差异无统计学意义（P〉0.05）。结论低浓度（0.125%）丁卡因用于临床硬膜外术后镇痛有效,安全,经济适用,值得临床推广。

Clinical observation of Tetracaine and Bupivacaine combined with Fentanyl and Droperidolre respectively in PECA

Objective To evaluate the validity and adverse reaction of Fentanyl,Bupivacaine,Tetracaine and Droperidol in PECA.Methods Eighty patients were randomly divided into two groups.One group was the experimental Ⅰ,in which 12.5 mL 1% Tetracaine,0.7 mg fentanyl and 5 mg droperidol were given;The other group was the controlled Ⅱ,in which 16.7 mL 0.75% Tetracaine,0.7 mg fentanyl and 5 mg Droperidol were given.The total volume of both group was 100 mL,Continuous measurement for 2 mL/h,15min for each time a locking time,maximum output of 2 mL in each one hour,the analgesia was over in 3 days after operative.The analgesia effect of analgesia scores and sedation scores were record in the 6th hour and in the 24th hour.Results The difference of analgesia effects,analgesia scores and sedation scores were not significant between the two groups(P > 0.05).Conclusion It is safety,effective,cheap and practicable that the 0.125% Tetracaine is recommended for PEAC.