摘要
目的观察吗啡、芬太尼用于妇科病人术后硬膜外镇痛(PCEA)的镇痛效果及不良反应。方法80例择期妇科手术患者,ASAⅠ～Ⅱ级,随机分为两组,每组40例。A组选用0.004%吗啡+0.02%甲氧氯普胺+0.01%地塞米松+0.1%罗比卡因;B组选用0.000 3%芬太尼代替A组配方中的0.004%吗啡。均用PCA泵(200 ml)行PCEA,以LCP模式(负荷剂量A组吗啡1.5 mg,B组芬太尼0.05 mg均稀释成5 ml首次注入,持续输注剂量4 ml/h+PCA每次0.5 ml)。结果(1)综合镇痛质量,A组与B组无明显差异(P>0.05);(2)A组尿潴留、恶心、呕吐、皮肤瘙痒、嗜睡等发生率较B组高(P<0.01)。结论吗啡、芬太尼PCEA用于妇科术后镇痛均可取得满意的效果,但芬太尼较吗啡的不良反应明显少。
Objective To observe the analgestic and adverse effects of morphine and fentanyl in patient controlled epidural analgesia （PCEA） in gynecological patients. Methods A total of 80 ASA I and II gynecological patients were randomized into two groups. Group A received 0. 004% of morphine, 0.01% of metoclopramide, 0.01% of dexamethasone and 0.01% of ropivacine, and Group B was administered 0. 0003% .of fentanyl instead of morphine （ i. e. the other drugs were the same）. Postoperative analgesia was provided by PCA pump with LCP model （ load dosage 5ml ＋ lasting dosage 4ml/h ＋ 0.5ml per time）. Results （ 1 ） There was not any significant difference in the analgesic effects between the two groups （ P 〉 0.05 ）. （2） Complications such as urinary retention, nausea, vomiting, itch and sleeping were significntl milder in Group A than in Group B （ P 〈 0.05 ）. Conclusion Morphine and fentanyl are both satisfactory when used for PCEA in gynecological patients, but the adverse effects are much less with fentayl than with morphine.
出处
《临床军医杂志》
CAS
2009年第2期227-229,共3页
Clinical Journal of Medical Officers
关键词
吗啡
芬太尼
术后硬膜外镇痛
morphine
fentayl
patient controlled epidural analgesia
