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目的 比较下腹部手术后０－２％ 罗哌卡因（Ｒｏｐ） 或０－２％ 布比卡因（Ｂｕｐ） 与吗啡（Ｍｏｒ）配伍病人自控硬膜外镇痛（ＰＣＥＡ） 的效应。方法 选择经腹子宫全切术的病人６６ 例（ＡＳＡⅠ～Ⅱ级），随机分成三组双盲对照观察，Ｒ组（ｎ＝ ２２）：镇痛药为０－２％ Ｒｏｐ ＋０－０１％ Ｍｏｒ，采用英国Ｇｒａｓｅｂｙ－ ９３００ ＰＣＡ泵，以ＬＣＰ模式给药；Ｂ组（ｎ＝２２） ：镇痛药为０－２ ％ Ｂｕｐ ＋０－０１ ％ Ｍｏｒ，ＰＣＡ方法同Ｒ组；Ｃ组（ｎ ＝ ２２）：镇痛药为０－９％ 生理盐水＋ ０－０１％Ｍｏｒ（对照组），其方法同Ｒ组。结果 Ｒ组、Ｂ组、Ｃ组２４ ｈ ＰＣＥＡ所需的镇痛液量分别为２０－３ ±５－１ ｍＬ，２０－２ ±４－４ ｍＬ，２６－４±７－２ ｍＬ；镇痛效果：Ｒ组≈Ｂ组＞ Ｃ组（ Ｐ＜ ０－０１～０－０５），表现为：Ｒ组、Ｂ组分别从ＰＣＥＡ４５ ｍｉｎ 静息和咳嗽时ＶＡＳ评分一直明显低于Ｃ组；Ｄ／Ｄ比值：Ｃ组＞ Ｒ组≈Ｂ组（ Ｐ＜ ０－０５） ，三组病人术后下肢受阻滞的运动神经恢复至Ｂｒｏｍａｇｅ－２ 级所需的时间Ｂ 组＞ Ｒ组＞ Ｃ 组（ Ｐ＜ ０－０５），术后２ ｈ 无运动阻滞的病人Ｒ 组为６４％ ，Ｂ组３６ ％ ，Ｃ组７６％ ，术?
Objective To compare the effects of self-controlled epidural analgesia (PCEA) with 0-2% Rop or 0-2% Bup with morphine after lower abdominal surgery. Methods Sixty-six patients (ASA Ⅰ ~ Ⅱ) undergoing total abdominal hysterectomy were randomly divided into three groups. The patients in group R (n = 22) were treated with 0-2% Rop and 0-01% Mor Group B (n = 22): analgesics were 0-2% Bup + 0-01% Mor and PCA was the same as Group R; Group C (n = 22) ): Analgesics 0-9% saline + 0-01% Mor (control group), the same method with the R group. Results The amount of analgesia required for 24 h PCEA in groups R, B and C were 20-3 ± 5-1 mL, 20-2 ± 4-4 mL and 26-4 ± 7-2 mL, respectively. Analgesia Results: The VAS scores of group R and group B were significantly lower than those of group C (P <0.01) D ratio: C group> R group ≈B group (P <0-05), the time required for recovery of the motor nerve in the lower limbs to the Bromage-2 level was lower in the three groups. Group B> R group> C group P <0-05). The patients in group R were 64% in group B, 36% in group B and 76% in group C at 2 hours after operation