论文部分内容阅读
目的 :观察小剂量芬太尼联合罗哌卡因硬膜外持续输注在前列腺切除术后的镇痛作用及安全性。方法 :将符合条件的经耻骨上前列腺切除术后患者 12 0例分为两组。治疗组 70例 ,采用芬太尼 5mg·mL 1 加罗哌卡因 1.875mg·mL 1 持续硬膜外输注 ;对照组 5 0例 ,采用传统的镇痛方法。比较两组目视模拟标尺法评分 (VAS评分 )、膀胱痉挛、肛门排气时间、冲洗液清亮时间、手术前后生命体征变化及术后的不良反应。结果 :与对照组相比 ,治疗组VAS评分明显降低 ,膀胱痉挛发生明显减少 ,程度较轻 ,冲洗液清亮时间较短 ;两组肛门通气时间、停用镇痛泵后两组膀胱痉挛发生率相近。治疗组恶心、呕吐并有头晕及皮肤瘙痒 1例 ,停镇痛泵后症状消失 ;对照组平均动脉压明显升高 6例 ,心动过速 8例。结论 :小剂量罗哌卡因联合芬太尼硬膜外镇痛效果确切 ,可明显减少膀胱痉挛及出血 ,促进患者恢复 ,且安全性较好
Objective: To observe the analgesic effect and safety of low dose fentanyl and ropivacaine continuous epidural infusion after prostatectomy. Methods: A total of 120 patients who underwent suprapubic prostatectomy were divided into two groups. The treatment group was treated with epidural infusion of fentanyl 5mg · mL 1 plus ropivacaine 1.875mg · mL 1; control group, 50 patients received traditional analgesia. The visual analog scales (VAS score), bladder spasm, anal exhaust time, washing fluid clearing time, changes of vital signs before and after surgery and postoperative adverse reactions were compared between the two groups. Results: Compared with the control group, the VAS score of the treatment group was significantly decreased, the incidence of bladder spasm was significantly reduced, to a lesser extent, and the cleaning fluid clearing time was shorter. The anal ventilation time and the incidence of bladder spasm similar. Treatment group nausea, vomiting and dizziness and pruritus in 1 case, stopped analgesia pump symptoms disappeared; control group, mean arterial pressure was significantly higher in 6 cases, tachycardia in 8 cases. CONCLUSIONS: Low-dose ropivacaine combined with fentanyl has the exact effect of epidural analgesia, which can obviously reduce bladder spasm and hemorrhage, promote the recovery of patients and is safe