苯海拉明对术后吗啡静脉自控镇痛不良反应疗效的影响

Effect of Benadryl on Morphine Side Effects during Patient Control Vein Analgesia after Thoracic Surgery

目的 探讨术毕前应用苯海拉明对术后吗啡静脉自控镇痛引起的不良反应的预防效果。方法 42例胸科手术患者,随机分为苯海拉明实验组(A组),对照组(B组),每组21例。A组术毕前30min静脉注射苯海拉明10mg,术毕开放静脉镇痛(PCVA)。B组术毕开放PCVA。两组患者的背景剂量、单次自控剂量、锁定时间均为一致。并分别于术后2、4、6、12、24、48h各时点观察并记录:呼吸频率(RR)、心率(HR)、平均动脉压(MAP)、血氧饱和度(SPO2 )各项指标的变化;不良反应:恶心、呕吐、皮肤瘙痒等发生率;疼痛评分(VAS)的分值。结果 两组间比较,RR、HR、MAP、SPO2 各项指标的变化无明显差异,而恶心、呕吐、皮肤瘙痒的不良反应,A组明显低于B组,镇痛开始4h内单次自控按压次数,B组多于A组(P<0 05)。结论 术毕前静脉注射苯海拉明,能有效预防吗啡术后镇痛所致的恶心、呕吐和皮肤瘙痒等副反应。

Objective To study the effect of benadryl on side effects induced by morphine during patient control vein analgesia after Thoracic Surgery.Methods 42 patients underwent thoracic operation were randomized into two groups,each group consisting of 21 cases.Group A were injected benadryl 10mg 30 minutes preceding operation finished,while group B were didn't.Both groups were connected patient control vein analgesia pump and they had the same background dose,single control dose and lock time.Both groups' RR, HR, MAP,SPO 2,side effects and VAS value were recorded at the time of 2,4,6,12,24,48h after surgery respectively.Results Group A compared with group B,there were no statistic meaning in RR,HR,MAP and SpO 2,but side effects and PCA pressed times in 4 hours, group A wre less than group B(P<0.05).Conclusion Benadryl can prevent nausea, vomiting and itch induced by morphine during patient control vein analgesia.