吗啡与曲马多用于术后硬膜外自控镇痛的效果评价

Evaluation of Postoperative patient-controlled epidural analgesia with morphine or tramadol

目的:观察吗啡与曲马多分别配伍0.125%布比卡因在硬膜外麻醉术后病人自控镇痛中的效果与不良反应。方法:60例手术病人,随机分成3组:曲马多组(T组),吗啡组(M组)和对照组(C组)。均采用硬膜外麻醉,三组均采用电子镇痛泵,镇痛液为0.125%布比卡因100mL。术后分时间段访视,观察镇痛、镇静效果及不良反应。结果:T组与M组病例镇痛、镇静效果比较无显著性差异,均明显优于C组(P<0.05);曲马多组恶心呕吐率高于吗啡组(P<0.05),皮肤瘙痒、尿潴留吗啡组高于曲马多组(P<0.05)。结论:吗啡与曲马多分别配伍0.125%布比卡因在硬膜外麻醉术后病人自控镇痛中均能取得满意的效果。临床运用中要注意病人的不同情况,减少不良反应的发生。

Objective: To evaluate the efficacy and side effect of the postoperative patient-controlled epidural analgesia(PCEA) with morphine or tramdol with 0.125% bupivacaine. Methods: 60 postoperative patients undergoing epidural analgesia were randomly divided into three groups: tramdol group (T group),morphine group (M group) and control group (C group). All of them were used electric pump of analgesia in which was 0.125% bupivacaine 100mL. The efficacy of analgesia and sedation and the side effect of nausea, vomiting, hypersomnia, respiratory inhibition, skin itching and urinary retention were recorded at different hours of post-operation. Results:The efficacy of analgesia and sedation of group T and group M was similar but significantly better than that of group C(P<0.05). The incidence of nausea and vomiting of group T was higher than that of group M(P<0.05), while that of skin itching and urinary retention was lower than that of group M(P<0.05). Conclusion: On one hand morphine or tramdol with 0.125% bupivacaine can provide with a satisfied efficacy in PCEA. On the other hand, the patients' individual condition must be considered in order to reduce the incidence of side effect in clinic.