高乌甲素与吗啡硬膜外术后镇痛的临床对照研究

Clinical control study of lappaconitine vs morphine for postoperative epidural analgesia

目的 :探讨高乌甲素硬膜外术后镇痛的效果 ,并与吗啡比较。方法 :手术病人 10 9例 ,采用随机双盲试验方法 ,分为 2组。均采用硬膜外麻醉 ,术毕注入镇痛负荷量 ,然后以 2mL·h- 1匀速注入镇痛液 ,镇痛液中含吗啡或高乌甲素。于术后 6 ,12 ,2 4 ,4 8h观察 2组镇痛效果、不良反应发生率及血浆皮质醇含量变化。结果 :2组各有 5 0例病人完成研究 ,均有满意的镇痛效果 ,恶心、呕吐、皮肤瘙痒发生率均较低 ,且组间无显著差异 (P >0 .0 5 )。高乌甲素组尿潴留发生率 18% (9/ 5 0 ) ,明显低于吗啡组6 8% (39/ 5 0 ) (P <0 .0 1)。 2组血浆皮质醇比较无显著差异 (P >0 .0 5 )。结论 :高乌甲素硬膜外术后镇痛能取得满意镇痛效果 ,对无需留置导尿而又要求术后镇痛的病人更为合适。

AIM: To explore the effects of lappaconitine for postoperative epidural analgesia and compared with morphine. METHODS: One hundred and nine operative patients were randomly divided into two groups. All of them were applied epidural anesthesia. When the operation was over,a load dose of analgesia was given to each patient. Then liquor of analgesia 2 mL·h -1 was injected equally,which contained lappaconitine or morphine. Analgesia effect,adverse reactions and the changes of plasma cortisol were observed in two groups at post-operation 6,12,24, 48 h. RESULTS: Fifty patients of both lappaconitine and morphine groups gained satisfactory analgesia effect( P >0.05). The adverse reactions of nausea-vomiting and itch of skin was lower equally in two groups( P >0.05),but the incidence of urinary retention in lappaconitine group(18 % ) were significantly lower than those (68 %) in morphine group( P <0.01). The content of plasma cortisol was no significant difference between two groups( P >0.05). CONCLUSION: Lappaconitine for postoperative epidural analgesia can gain satisfactory analgesia effect. It is further suitable for those patients who need not to detain urethral catheterization and to demand postoperative analgesia.