Tsui S L, Lee D K, Ng K F, Chan T Y, Chan W S, Lo J W
Department of Anaesthesiology, Queen Mary Hospital, Hong Kong.
Anaesth Intensive Care. 1997 Oct;25(5):476-81. doi: 10.1177/0310057X9702500504.
One hundred and twenty women undergoing gynaecological abdominal operations were randomized to receive either epidural bupivacaine 0.0625% + fentanyl 3.3 micrograms/ml infusion (Group EPI, n = 57), or patient-controlled intravenous morphine analgesia (Group PCA, n = 54) for postoperative pain relief. The groups were comparable in demographic data, types and duration of operation. Group EPI achieved significantly lower verbal rating scale of pain (VRS) at rest at 0, 4, 12, 16, 20, 28 and 40th postoperative hours. The VRS during cough were also significantly lower in Group EPI at 0, 4, 8, 12, 28 and 36th postoperative hours. None of the patients had respiratory depression or hypotension. Nausea/vomiting occurred in 52.6%/33.3% of patients in Group EPI and 52.7%/37.0% in Group PCA. Most patients (84.2% in Group EPI and 72.2% in Group PCA) rated their pain management as "good". We conclude that epidural infusion of bupivacaine 0.0625% and fentanyl 3.3 micrograms/ml provide better analgesia than patient-controlled intravenous morphine after gynaecological laparotomy.
120名接受妇科腹部手术的女性被随机分组,分别接受0.0625%布比卡因+3.3微克/毫升芬太尼硬膜外输注(EPI组,n = 57)或患者自控静脉吗啡镇痛(PCA组,n = 54)以缓解术后疼痛。两组在人口统计学数据、手术类型和持续时间方面具有可比性。EPI组在术后0、4、12、16、20、28和40小时静息时的疼痛视觉模拟评分(VRS)显著更低。EPI组在术后0、4、8、12、28和36小时咳嗽时的VRS也显著更低。所有患者均未出现呼吸抑制或低血压。EPI组和PCA组恶心/呕吐的发生率分别为52.6%/33.3%和52.7%/37.0%。大多数患者(EPI组84.2%,PCA组72.2%)对其疼痛管理评价为“良好”。我们得出结论,妇科剖腹术后,硬膜外输注0.0625%布比卡因和3.3微克/毫升芬太尼比患者自控静脉吗啡镇痛效果更好。