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1、泵速對(duì)剖宮產(chǎn)術(shù)后硬膜外鎮(zhèn)痛效果的影響【摘要】目的:觀察泵速對(duì)剖宮產(chǎn)術(shù)后硬膜外鎮(zhèn)痛效果的影響。方法:60例ASAⅠ~Ⅱ級(jí)的剖宮產(chǎn)術(shù)病人,均在硬膜外麻醉下完成手術(shù)并實(shí)行硬膜外術(shù)后鎮(zhèn)痛,根據(jù)泵速不同將病人隨機(jī)分為三組,每組20例,A組:0.15%布比卡因+芬太尼0.4mg,100mil泵速2.1mil/h;B組:0.15%布比卡因+芬太尼0.4mg,168mil,泵速3.5mil/h;C組:0.15%布比卡因+芬太尼0.4mg,240mil,泵速5ml/h。觀察病人術(shù)后6h、18h、24h、48h,鎮(zhèn)痛效果及不良反應(yīng)。結(jié)果:三組患者年齡、體重、手
2、術(shù)時(shí)間及術(shù)中絕對(duì)平面無(wú)顯著性差異(P>0.05);術(shù)后各時(shí)間段B、C兩組VAS評(píng)分均低于A組(P<0.05);術(shù)后24hB、C兩組的阻滯節(jié)段數(shù)均大于A組(P<0.05);三組病人術(shù)后鎮(zhèn)痛的副作用,C組的下肢麻木發(fā)生率較A、B兩組高(P<0.05)。結(jié)論:泵速直接影響剖宮產(chǎn)術(shù)后硬膜外鎮(zhèn)痛效果,3.5mil/h的泵速既可產(chǎn)生良好的鎮(zhèn)痛效果,又不影響病人的下肢活動(dòng),可作為首選。?【關(guān)鍵詞】泵速??剖宮產(chǎn)術(shù)??硬膜外術(shù)后鎮(zhèn)痛 Theinfluenceofpumpspeedtotheeffectsofepiduralanalgesiaafterce
3、sareansection WangFeng-lan1??KouLi-hua1??Liyu-mei1etal?。―epartmentofAnesthesiology,BeijingDaxingdistrictpeople’shospital,102600,China)??【Abstruct】Objective:Toobservetheinflunceofpumpspeedtotheeffectsofepiduralanalgesiaaftercesareansection.Methods:ASAⅠ~Ⅱ60patientsundergoin
4、gcesareansectionwereallreceivedepiduralanalgesiaandpost-operativeepiduralanalgesia.Accordingtodifferentpumpspeed,patientswererandomlydividedintothreegroupswith20caseseach.GroupA:0.15%Bupivacaine+Fentanyl0.4mg,100ml,pumpspeedwas2.1ml/h;GroupB:0.15%Bupivacaine+Fentanyl0.4mg,
5、168ml,pumpspeedwas3.5ml/h;GroupC:0.15%Bupivacaine+Fentanyl0.4mg,40mlpumpspeedwas5ml/h.TheVASandsideeffectswererecordedat6h.18h.24h.48hofpostoperation.Results:AgeWeightOperationtimeandthenumbersofblocksegmentsinoperationshowednodifferenceinthreegroups.(P>0.05);Atallrecorded
6、pointsofpostoperation,theVASofgroupBandgroupCwerelowerthangroupA(P<0.05):At24hofpostoperation,ThenumbersofblockofsegmentsofgroupBandgroupCweremorethangroupA(P<0.05);Aboutthesideeffectsinthreegroups,the?rateoflegsnumbingroupCwashigherthangroupAandgroupB(P<0.05).Conclusion:T
7、hepumpspeedcaninfluencetheeffectsofepiduralanalgesiaaftercesareansection.Thespeedwasof3.5ml/hcanprovideagoodanalgesiaandnolegsnumb,itisthebestchoice.【Keywords】Pumpspeed??cesareansection??epiduralpostoperativeanalgesia 硬膜外術(shù)后鎮(zhèn)痛已廣泛應(yīng)用于臨床,其鎮(zhèn)痛效果肯定,但不同泵速對(duì)鎮(zhèn)痛效果的影響報(bào)道較少,我們采用不同泵速對(duì)剖宮產(chǎn)
8、病人進(jìn)行術(shù)后鎮(zhèn)痛,觀察其鎮(zhèn)痛效果及不良反應(yīng),旨在選擇最適的泵速,以期既能產(chǎn)生滿意的鎮(zhèn)痛效果,又把副作用減到最低。1?資料與方法?1.1?一般資料?剖宮產(chǎn)病人60例,年齡20-32