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1、左旋布比卡因复合不同剂量舒芬太尼术后硬膜外自控镇痛临床对比探究［摘要］目的探讨和分析左旋布比卡因复合不同剂量舒芬太尼用于子宫切除术后硬膜外自控镇痛的临床效果、安全性及意义。方法收集拟行子宫切除术且ASAI〜II级的患者135例，随机分为A、B和C组，各45例。三组术后均采用LCP模式镇痛，A组给予0.2%左旋布比卡因混合舒芬太尼0.4Pg/mL；B组给予0.2%左旋布比卡因混合舒芬太尼0.6Ug/mL；C组给予0.2%左旋布比卡因混合舒芬太尼0.8ug/mLo观察并记录各组患者镇痛泵开启前及开启后4、8、12及24h的MAP、HR、视觉模拟法(V
2、AS)评分、Ramsay评分、术后不良反应及并发症等情况。结果三组24h舒芬太尼平均用量比较，差异均有统计学意义(均P<0.05)；B组和C组镇痛效果于给药后8、12及24h明显优于A组(P<0.05)；B组和C组患者镇静效果于给药后12及24h明显优于A组(P<0.05)；与A组和B组相比C组患者出现恶心、呕吐及瘙痒等不良反应明显增多(P<0.05),B组和C组追加镇痛药患者显著少于A组(P<0.05)o结论经腹子宫切除术后硬膜外自控镇痛应用0.2%左旋布比卡因配伍舒芬太尼0.6ug/mL具有镇痛效果满意、安全性高和不良反应少等优点，值得临床推
3、广。［关键词］左旋布比卡因；舒芬太尼；硬膜外；自控镇痛［中图分类号］R614［文献标识码］A［文章编号］1673-7210(2012)08(b)-0072-03ClinicalcomparativestudyonLevobupivacainecompositeofdifferentdosesofSufentan订forpostoperativeepiduralcontrolledanalgesiaPUPengfei1XIEYubo2Sanda3Aichatou31.DepartmentofAnesthesiology,TraditionalChi
4、neseMedicineHospitalofBeihaiCity,GuangxiZhuangAutonomousRegion,Beihai536000,China；2.DepartmentofAnesthesiology,theFirstAffiliatedHospitalofGuangxiMedicalUniversity,GuangxiZhuangAutonomousRegion,Nanning530021,China；3.DepartmentofAnesthesiology,MaradiProvinceCentralHospital,Mar
5、adi999056,Niger［Abstract］ObjectiveToexploreandanalyzetheclinicaleffectsofpostoperativepatient-controlledepiduralanalgesia,securityandsignificancebyLevobupivacainecompositeofdifferentdosesofSufentanilforhysterectomy.Methods135casesofpatientswhounderwenthysterectomyandASAI-IIwe
6、redividedintogroupA,BandC,each45cases・ThethreegroupswereusedpostoperativeanalgesiaoftheLCPmode.ThepatientsofgroupAweregiven0.2%LevobupivacainemixedwithSufentanil0.4yg/mL；thepatientsofgroupBweregiven0.2%LevobupivacainemixedwithSufentardl0.6□g/mL；thepatientsofgroupCweregiven0.2
7、%LevobupivacainemixedwithSufentanil0.8ug/mL.TheMAP,HR,visualanalogscale(VAS)scorewereobservedandrecorded,Ramsayscoreandpostoperativeadverseeventsandcomplicationsatthetimeofanalgesiapumpwasturnedonafter0,4,8,12and24h.ResuItsThethreegroups24hSufentanilaverageamountwerecompared,
8、andtherewerestatisticallysignificant(P<0.05)；8,12and24hafteradminist
