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目的 :观察阴式全宫切除术后硬膜外单次注射丁丙诺啡和 /或布比卡因的镇痛效果.方法 :180例择期阴式全宫切除术患者随机分为 5组 ,分别单次注射等容量生理盐水、0 .12 5%布比卡因、丁丙诺啡 0 .15mg、丁丙诺啡 0 .15mg + 0 .12 5%布比卡因或接自控镇痛泵用吗啡行PCEA治疗.结果 :对照组患者疼痛主要在术后的前 12h内 ,以 4~ 8h为著.各镇痛组均取得较好的镇痛效果 ,但单纯布比卡因组VAS评分较高 ,吗啡组较低 ,吗啡组用药量和副作用明显增加.结论 :单次硬膜外术后镇痛用于阴式全宫切除术简便易行 ,效果良好 ,其中以丁丙诺啡 0 .15mg + 0 .12 5%布比卡因 9ml为佳.“,”Objective: To observe the effect of postoperative analgesia by single epidural injection of buprenorphine or bupivacaine into patients undergoing vaginal hysterectomy. Methods: 180 patients undergoing vaginal hysterectomy were divided into 5 groups randomly. The same volume of normal saline, 0.125% bupivacaine, 0.15 mg buprenorphine, 0.15 mg buprenorphine plus 0.125% bupivacaine were administered respectively or by PCEA with morphine. Results: Pain experienced by the control group was mainly during the first 12 hours after surgery, with most obvious feeling of pain in the period of 4~8 hours. All experimental groups achieved quite good results with regard to analgesia. However, in the bupivacaine group, VAS was higher, and in morphine group, VAS was lower, but the dosage of morphine and its side effects were obviously higher. Conclusion: Administration of single epidural injection for postoperative analgesia in patients undergoing vaginal hysterectomy was simple and convenient, with good results, and application of 0.15 mg buprenorphine plus 0.125%bupivacaine proved to be more ideal.