罗哌卡因-芬太尼用于老年人上腹部手术硬膜外镇痛的观察

目的观察罗哌卡因-芬太尼用于老年人上腹部手术硬膜外镇痛的效果.方法 32例上腹部手术的老年人,随机分两组,即R组(罗哌卡因-芬太尼)和B组(布比卡因-芬太尼).观察镇痛效果及副作用.结果两组病人安静时评分及每天用量无显著性差异(P＞0.05),术后1,2,3d咳嗽时VAS评分R组低于B组(P＜0.05),而BCS评分R组高于B组(P＜0.05);术后第1d给药有效次数和给药的比值B组低于R组(P＜0.05).两组副作用无显著差异.结论罗哌卡因-芬太尼和布比卡因-芬太尼均可用于老年人上腹部手术的硬膜外镇痛,且前者明显优于后者.

Evaluation of ropivacaine-fentanyl for patient-controlled epidural analgesia after operation of upper abodominal surgery in elderly

Objective: To evaluate the effect of patient-controlled epidural analgesia (PCEA) after operation of upper abodominal surgery in the elderly with Ropivacaine-Fentanyl and Bupivacaine-Fentanyl . Methods: 32 elderly patients (above 65 years), scheduled for elective upper abodominal surgery, were divided randomly two groups, i.e. Ropivacaine group (R=16) and Bupivacaine group (B=16). Results: The two groups were comparable with respect to demographic data. Postoperative analgesia was satisfactory in all two groups. When rest, VAS score and BCS score were no difference in all two groups (P >0.05); when cough, VAS score in R group was slower than in B group, and BCS score in R group was larger than in B group (P <0.05). The ratio of the effective amount of patient-controll to the volume of patient-control in B group was slower than in R group (P <0.05). There was no significant difference in the percentage of patients with adverse effects. Conclusions: PCEA after upper abodominal surgery in the elderly is satisfactory in all two groups during 72 hours and R group is better than B group.