SO SÁNH TÁC DỤNG KHÔNG MONG MUỐN CỦA PHƯƠNG PHÁP GIẢM ĐAU NGOÀI MÀNG CỨNG BỆNH NHÂN TỰ ĐIỀU KHIỂN BẰNG HỖN HỢP ROPIVACAIN 0,125% - FENTANYL 2µG/ML VỚI BUPIVACAIN 0,125% - FENTANYL 2µG/ML

Abstract

Objective: To evaluate the impact of certain indices on circulation, respiration, and some adverse effects when using the patient-controlled epidural analgesia method with a mixture of 0.125% ropivacaine - 2μg/ml fentanyl compared to 0.125% bupivacaine - 2μg/ml fentanyl after abdominal surgery. Subjects and Methods: A controlled clinical intervention study was conducted on 82 patients using the PCEA method after open upper abdominal surgery at Huu Nghi General Hospital in Nghe An from February 2022 to August 2022. Results: The rate of systolic blood pressure drop to <10%, 10-20%, >20% was 82.9%/14.6%/2.4% in the RF group and 68.3%/22%/9.8% in the BF group. At times H0/H0.25, the mean blood pressure in the RF group was 96.40 ± 4.97/92.29 ± 5.0 mmHg, corresponding to 97.58 ± 7.41/93.91 ± 5.63 mmHg in the BF group. The mean heart rate of the RF and BF groups at times H0/H0.25 was 91.90 ± 8.19 beats/min/82.54 ± 5.44 beats/min and 93.80 ± 8.67 beats/min/83.32 ± 5.97 beats/min, respectively. The mean respiratory rate at times H0/H0.25 in the RF group was 21.20 ± 3.5 breaths/min/17.20 ± 2.40 breaths/min, and in the BF group it was 20.83 ± 3.45 breaths/min/17.12 ± 2.39 breaths/min. The SpO2 rate at times H0/H0.25 showed that the average SpO2 in the RF group was 96.22 ± 1.52/97.80 ± 1.60, and in the BF group it was 96.49 ± 1.32/97.95 ± 1.6. The sedation scores at time H0 in the RF/BF groups were 1.56 ± 0.50/1.59 ± 0.49, and after analgesia administration were 2.24 ± 0.44/2.17 ± 0.39. The rate of nausea and vomiting in the RF/BF groups was 7.3%/14.6%. No cases of sensory disturbances or upper/lower limb motor inhibition were encountered. Itching and muscle tremors were observed in 9.8%/4.9% and 4.9%/12.2% of the RF/BF groups, respectively. Conclusion: The rate of blood pressure drop > 20% in the ropivacaine group was lower than in the bupivacaine group (p>0.05). Heart rate, respiratory rate, and SpO2 were comparable between the two groups. The rates of nausea, vomiting, and muscle tremors were lower in the ropivacaine group, while the rate of itching was higher than in the bupivacaine group.