Jayr C, Beaussier M, Gustafsson U, Leteurnier Y, Nathan N, Plaud B, Tran G, Varlet C, Marty J
Institut Gustave Roussy, Département d'Anesthésie, Villejuif, France.
Br J Anaesth. 1998 Dec;81(6):887-92. doi: 10.1093/bja/81.6.887.
We have compared the quality of three regimens of postoperative analgesia (continuous epidural administration of ropivacaine (Ropi. group), epidural ropivacaine and patient-controlled analgesia (PCA) with i.v. morphine (Ropi. + PCA group) and PCA morphine alone (PCA group)) during the first postoperative 24 h in a multicentre, randomized, prospective study. Postoperative analgesia was studied in 130 patients after major abdominal surgery performed under general anaesthesia. The ropivacaine groups received 20 ml of epidural bolus ropivacaine 2 mg ml-1 via the epidural route at the end of surgery, followed by continuous infusion of 10 ml h-1 for 24 h. The Ropi. + PCA group also had access to i.v. PCA morphine 1 mg, with a 5-min lockout. The PCA group received morphine as the sole postoperative pain treatment. The two ropivacaine groups had lower pain scores (P < 0.01) than the PCA group. Morphine consumption was higher in the PCA group (P < 0.05) than in the two ropivacaine groups. The quality of pain relief was rated as good or excellent in 79-85% of patients in the three groups. The percentage of patients without motor block increased between 4 and 24 h from 61% to 89% in the Ropi. group, and from 51% to 71% in the Ropi. + PCA group.
在一项多中心、随机、前瞻性研究中，我们比较了三种术后镇痛方案（罗哌卡因持续硬膜外给药（罗哌卡因组）、硬膜外罗哌卡因联合静脉注射吗啡患者自控镇痛（罗哌卡因+PCA组）和单纯PCA吗啡（PCA组））在术后24小时内的效果。对130例在全身麻醉下接受腹部大手术的患者进行了术后镇痛研究。罗哌卡因组在手术结束时经硬膜外途径给予20ml负荷剂量的2mg/ml罗哌卡因，随后以10ml/h的速度持续输注24小时。罗哌卡因+PCA组还可静脉注射PCA吗啡1mg，锁定时间为5分钟。PCA组将吗啡作为唯一的术后疼痛治疗药物。两个罗哌卡因组的疼痛评分均低于PCA组（P<0.01）。PCA组的吗啡消耗量高于两个罗哌卡因组（P<0.05）。三组中79%-85%的患者疼痛缓解质量被评为良好或优秀。罗哌卡因组无运动阻滞的患者百分比在4至24小时之间从61%增加到89%，罗哌卡因+PCA组从51%增加到71%。
