硬膜外吗啡和曲马多用于术后镇痛的临床研究

THE CLINICAL STUDY OF POSTOPERATIVE EPIDURAL ANALYGESIA WITH MORPHINE AND TRAMADOL.

目的:研究吗啡和曲马多单次注入硬膜外术后镇痛效果和不良反应。方法:选择剖宫产手术患者,随机分成两组,于腰2～3间隙行硬膜外穿刺。局麻药使用利多卡因、布比卡因混合液。吗啡组(M组)药物配方为2mg ,以生理盐水稀释到10ml。曲马多组(T组)药物配方曲马多10 0mg ,以生理盐水稀释到10ml。关腹时将各组药物注入硬膜外腔,观察注药前、后10minSBP、DBP、HR、SpO2 的变化,2 4h内镇痛效果及不良反应。结果:两组药物对循环呼吸功能均无明显改变。镇痛效果均较好,T组优于M组。不良反应,M组高于T组。结论:硬膜外曲马多用于术后镇痛效果好,不良反应少。

Objective:To study the analgesic efficacy and disadvantageous influence of postoperative analgesia with morphine or tramadol injection by epidural.Methods:Sixty pregnant women by cesarean section were randomly divided into two groups with thirty women for each group.Epidural anesthesia was performed at L_ 2～3 interspace with mix drug of 2% lidocanine hydrochloride 10 ml and 0.5% bupivacaine hydrochloride 10 ml.Postoperative analgesia was performed with morphine hydrochloride 2 mg+normal salt solution 8ml(group M) or tramadol hydrochloride 100 mg+normal salt solution 8 ml(group T).As the abdomen was closed,the drug solution was injected by epidural catheter.Arterial systolic blood press(SBP)、Arterial diastolie blood press(DBP)、heart rate(HR) and satisfy degree of puls oxygen(SpO_2)were measured at 10 min before or after drug injection.The analgesic efficacy and disadvantageous in fluence of postoperative analgesia in 24 hours were observed.Results:The changes of circulation and respiration were not significant in the two groups.The efficacy of analgesic was satisfactory for the two group,but it was better in group T than in group M.The disadvantageous in fluences in group M was more than in group T.Conclusion:The postoperative analgesic efficacy of tramadol was better than morphine,meantime its disadvantageous influences were less than morphine.