0.15%左旋布比卡因用于下肢术后镇痛的临床观察

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1、0.15%左旋布比卡因用于下肢术后镇痛的临床观察作者：王兴高，刘平，余清河，曹自华，黎葵英，鄂苏评【关键词】,,左旋布比卡因；,,硬膜外镇痛；,,下肢手术　　摘要：目的：观察0.15%左旋布比卡因用于下肢手术病人术后硬膜外镇痛的临床效应。方法：60例择期下肢手术病人随机分为2组，LBUP组和BUP组，每组30例。手术结束采用持续硬膜外输注镇痛，LBUP组采用0.15%左旋布比卡因加吗啡0.1mg/ml，BUP组采用0.15%布比卡因加吗啡0.1mg/ml，输注速度均为2ml/h。观察术后48h内的

2、VAS疼痛评分、患者对镇痛治疗总体印象评分、改良Bromage评分、术后活动能力及不良反应的发生情况。结果：两组病人在术后5个时段VAS疼痛评分、镇痛结束时对疼痛的总体评估、镇痛后4h改良Bromage评分及不良反应发生情况，组间比较并无显著性差异（P>0.05）；镇痛8h后LBUP组及BUP组分别有2例病人Bromage评分=2，至镇痛后16h恢复；术后24hLBUP组及BUP组分别有12例（40%）及11例（36.7%）的病人可以短时间行走，无显著性差异（P>0.05）。结论：0.

3、15%左旋布比卡因与0.15%布比卡因用于下肢手术后持续硬膜外输注镇痛，均可获得满意的镇痛效果，两种药物的镇痛疗效没有差别。9　　关键词：左旋布比卡因；硬膜外镇痛；下肢手术　　AComparisonStudyofEpiduralAnalgesiawith0.15%Levobupivacaineand0.15%BupivacaineAfterlowExtremityOperation　　Abstract：Objective:Toresearchtheefficacyofepiduralanalges

4、iawith0.15%levobupivacaineand0.15%bupivacaineafterlowextremityoperations.Methods:60ASAⅠ～Ⅱpatientsundergoinglowextremityoperationunderepiduralanalgesiawererandomlydividedintotwogroups,30casesineachgroups.Afteroperation,patientsingroupLBUPweregivenconti

5、nuousepiduralinfusionatarateof2ml/hwith0.15%levobupivacainecombinedwithmorphine0.1mg/ml，andingroupBUPwith0.15%bupivacainecombinedwithmorphine0.1mg/ml.TheVASscore,patients’overallimpressionoftreatment,modifiedBromagemotorscalescore,andseverityofsideeff

6、ectsafteroperationwererecorded.Result:TherewasnosignificantdifferenceinVASscoreat4h,8h,16h,24h,48h,andpatients’overallimpressionoftreatmentat48h,andmodifiedBromagemotorscalescoreat4h,andseverityofsideeffectsafteroperation(P>0.05).Butthereweretwoper

7、sonsingroupLBUPandgroup9BUPrespectivewhosemodifiedBromagemotorscalescorewastwoat8handrecoveredat16hafteroperation.Onthefirstpostoperativeday,therewasnosignificantdifferenceinpercentofpatientswhowereambulatoryforalittletimebetweengroupLBUPandgroupBUP(4

8、0%vs36.7%,P>0.05).Conclusion:Postoperativeepiduralinfusionwith0.15%levobupivacaineor0.15%bupivacainecanprovideeffectiveanalgesia.Theclinicefficacyof0.15%levobupivacaineand0.15%bupivacainewassame.　　Keywords：Levobupivacaine;Epiduralanalgesia;