摘要
目的:观察小剂量纳洛酮(50 ng·kg-1·h-1)对吗啡经静脉病人术后自控镇痛(PCIA)时恶心呕吐,首次排气时间及血浆胃动素水平的影响.方法:ASA Ⅰ~Ⅱ级子宫切除患者,术后使用吗啡PCIA.随机分成两组,双盲随访两组病人恶心呕吐,首次排气时间,镇痛效果,并检测血浆胃动素水平.结果:MN组镇痛效能优于M组,恶心呕吐发生率及程度降低,排气时间缩短;从入室到术毕,两组胃动素水平均升高,但M组在术后24 h内仍维持较高水平,而MN组在术后6 h明显降低,24 h有一定程度升高,42 h达分泌高峰.结论:小剂量纳洛酮可减少吗啡PCIA引起的恶心呕吐、促进病人胃肠动力恢复,其机制与延缓胃动素的分泌高峰有关.
Objective: To evaluate the effect of low-dose naloxone (50 ng· kg^-1·h^-1 ) on postoperative intravenous analgesic potency of morphine and investigate its relationship with postoperative nausea and vomiting (PONV), the time of first flatus, and plasn,a n,otilin in patients. Methods: The ASA Ⅰ to Ⅱ patients who underwent scheduled hysterectomies under spinal-epidural anesthesia were divided randomly into 2 groups. Patients in group M received morphine, and those in group MN received morphine and naloxone for pastoperative analgesia. Postoperative analgesic potency, PONV, and the time of first flatus were observed double-blindly, and the level of plasma motilin (MOT) was recorded. Results: The analgesic efficacy of group MN was significant better than that of group M ( P 〈 0.05 ). The incidence and degree of PONV decreased and the time of first flatus was shortened in group MN. The level of MOT increased throught operation( P 〈 0.05 ). The level of MOT was still high 24 hours after the operation in group M. But in group MN, the level of MOT obviously decreased 6 hours after the operation, increased 24 hours later, and reached the peak 42 hours later. Conclusion: Low dose of naloxone can reduce PONV induced by morphine in postoperative intravenous analgesia and stimulate the recovery of gastrointestinal motility by delaying the development o f the peak of MOT secretion.
出处
《中国医科大学学报》
CAS
CSCD
北大核心
2005年第5期482-484,共3页
Journal of China Medical University
基金
辽宁省科委自然科学基金资助项目(20032069)
关键词
吗啡
纳洛酮
术后镇痛
恶心呕吐
胃动素
morphine
naloxone
postoperative analgesia
postoperative nausea and vomitting
motilin