De Cosmo G, Congedo E, Mascia A, Adducci E, Lai C, Aceto P
Department of Anaesthesiology and Intensive Care, Policlinico Universitario A. Gemelli, Rome, Italy.
Anaesthesia. 2007 Oct;62(10):994-9. doi: 10.1111/j.1365-2044.2007.05184.x.
A prospective, randomised, double-blind study was conducted to compare the efficacy of two doses of levobupivacaine combined with sufentanil for continuous epidural infusion following thoractomy. A total of 72 patients undergoing lobectomy or pneumonectomy were enrolled. An epidural catheter was inserted between the levels of T4 and T6 before induction of anaesthesia and a loading dose of levobupivacaine and sufentanil was administered. At the end of surgery an epidural infusion was commenced at 5 mlxh(-1) and continued for 48 h. Patients were randomly allocated to receive either levobupivacaine 0.125% (group A) or 0.0625% (group B) and all patients also received sufentanil (1 microgxml(-1)). Visual analogue pain scores after coughing (VASi) were always higher in group B (p < 0.05); VAS pain scores at rest were higher for the first 4 h and at 16 and 28 h in group B (p < 0.05). Total morphine consumption and requests number was lower in group A (p < 0.05). Better pain relief was achieved using epidural 0.125% levobupivacaine.
进行了一项前瞻性、随机、双盲研究，以比较两种剂量的左旋布比卡因联合舒芬太尼用于开胸术后持续硬膜外输注的疗效。总共纳入了72例行肺叶切除术或全肺切除术的患者。在麻醉诱导前于T4和T6间隙插入硬膜外导管，并给予负荷剂量的左旋布比卡因和舒芬太尼。手术结束时，以5 mlxh(-1)开始硬膜外输注，并持续48小时。患者被随机分配接受0.125%左旋布比卡因（A组）或0.0625%左旋布比卡因（B组），所有患者还接受舒芬太尼（1 microgxml(-1)）。B组咳嗽后视觉模拟疼痛评分（VASi）始终较高（p < 0.05）；B组在最初4小时以及16和28小时静息时的VAS疼痛评分较高（p < 0.05）。A组吗啡总消耗量和需求次数较低（p < 0.05）。使用0.125%硬膜外左旋布比卡因可实现更好的疼痛缓解。
