PDF(Pubmed)
Abstract：
Introduction Persistent postoperative pain leads to impaired patient recovery and delays in discharge of patients. The aim was to compare the efficacy of 0.5% bupivacaine to two varying concentrations of ropivacaine, specifically 0.5% and 0.75%, along with fentanyl as a continuous epidural infusion in providing adequate pain relief for patients subjected to infraumbilical surgeries. Materials and methods A prospective randomized comparative study was carried out on 150 patients and was divided into three groups, namely group B, group R, and group RP. Group B indicates (0.5% bupivacaine), group R means (0.5% ropivacaine), and finally, group RP means (0.75% ropivacaine); the three groups had 50 patients each. Group B was administered an epidural infusion of bupivacaine at a concentration of 0.5%, group R was given 0.5% ropivacaine, and group RP was treated with 0.75% ropivacaine; all three groups included 40 mcg fentanyl. The duration of the motor and sensory blockade and the time needed for the first rescue analgesia after the stoppage of epidural infusion were assessed in all three groups. The data were statistically analyzed using the ANOVA, \"post hoc Tukey,\" and chi-square tests. Results Comparison of the duration of motor and sensory blockade among all three groups showed that group RP (0.75% ropivacaine with 2 mcg/cc fentanyl) had the longest duration of 328.8 and 406 minutes, and the difference was statistically significant (p < 0.001). Comparison of the time of stoppage of epidural infusion to the requirement of first rescue analgesia showed that the group that received 0.75% ropivacaine with 40 mcg fentanyl had the highest value of 258.6 minutes and was statistically significant (p < 0.001). Conclusion Epidural intraoperative infusion of 0.75% ropivacaine with fentanyl offers better postoperative pain relief as compared to both 0.5% bupivacaine and 0.5% ropivacaine with fentanyl.
摘要：
引言持续的术后疼痛导致患者康复受损和患者出院延迟。目的是比较0.5％布比卡因与两种不同浓度的罗哌卡因的疗效。具体为0.5%和0.75%，与芬太尼一起作为连续硬膜外输注，为进行脐下手术的患者提供足够的疼痛缓解。材料与方法对150例患者进行前瞻性随机对照研究,分为三组,即B组,R组,和组RP。B组表示（0.5%布比卡因），R组均值（0.5%罗哌卡因），最后，RP组均值（0.75％罗哌卡因）；三组各有50名患者。B组硬膜外灌注浓度为0.5%的布比卡因,R组给予0.5%罗哌卡因,RP组用0.75%罗哌卡因治疗;所有三组均包括40mcg芬太尼。在所有三组中，评估了硬膜外输注停止后运动和感觉阻滞的持续时间以及首次抢救镇痛所需的时间。数据采用方差分析进行统计分析，\"事后Tukey，\"和卡方检验。结果三组运动和感觉阻滞持续时间的比较显示，RP组（0.75％罗哌卡因加2mcg/cc芬太尼）的最长持续时间为328.8和406分钟，差异有统计学意义(p<0.001)。硬膜外输注停止时间与首次抢救镇痛要求的比较显示，接受0.75%罗哌卡因和40mcg芬太尼的组的最高值为258.6分钟，具有统计学意义(p<0.001)。结论术中硬膜外输注0.75％罗哌卡因和芬太尼比0.5％布比卡因和0.5％罗哌卡因芬太尼能更好地缓解术后疼痛。
