硬膜外罗哌卡因在台湾病人术后镇痛中的应用。

Wai-Keung Lee, Chun-Hsuan Li, L. Lee, C. Au, K. Yu, Chao‐Shun Tang
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引用次数: 3

摘要

背景:丙哌卡因是最新的长效酰胺局麻药。由于它的心血管毒性和神经毒性比布比卡因小,因此它是一种有吸引力的麻醉剂,用于临床麻醉和术后镇痛。本研究的目的是为台湾患者的平均体格与西方药典推荐剂量不完全一致,寻求合适的罗哌卡因术后镇痛剂量。方法选取成人患者105例,随机分为3组,评价硬膜外罗哌卡因在术后镇痛中的应用效果。A组患者硬膜外给予0.15%罗哌卡因,B组和C组患者分别给予0.125%和0.10%罗哌卡因。采用视觉模拟评分法(VAS)和改良Bromage评分法评估疼痛,并在术后24小时内的指定时间点记录不良反应。结果三组患者人口统计资料具有可比性。VAS评分A组(3.20 +/- 0.47)、B组(3.11 +/- 0.41)差异无显著性意义,C组(3.97 +/- 0.71)显著高于A、B组(P < 0.05)。结论根据本研究结果,我们认为0.125%罗哌卡因可为台湾患者提供满意的术后镇痛,且不良反应较少。
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Epidural ropivacaine for postoperative analgesia in Taiwanese patients.
BACKGROUND Ropivacaine is the latest long-acting amide local anesthetic. As it is less cardiovasculotoxic and neurotoxic than bupivacaine it is an attractive anesthetic agent used in clinical anesthesia and postoperative analgesia. This study was undertaken to seek for a suitable dosage of ropivacaine in postoperative analgesia for Taiwanese patients whose average physicality is not entirely compatible with the pharmacopeially recommended dosage for western people. METHODS For assessment of epidural ropivacaine for postoperative analgesia 105 adult patients were enrolled and randomly allotted to three groups. Patients in Group A were given epidurally 0.15% ropivacaine, while those in Group B and Group C were given 0.125% and 0.10% ropivacaine respectively. Pain was evaluated with visual analogue scale (VAS) and modified Bromage scale, and adverse effects were recorded at the designated points of time during the postoperative 24-hour period. RESULTS The demographic profiles were comparable among three groups. In VAS score, Group A (3.20 +/- 0.47) and B (3.11 +/- 0.41) did not differ much, while Group C (3.97 +/- 0.71) the score was signally higher than Group A and Group B (P < 0.05). Adverse effects, such as paraesthesia, nausea and urinary retention were observed more in Group A. CONCLUSIONS From the results of this study, we are of the opinion that 0.125% ropivacaine could provide a postoperative analgesia in Taiwanese patients to their satisfaction with less adverse effects.
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