硬膜外丁丙诺啡和吗啡术后镇痛及瘙痒与镇痛效果的临床观察

Observation of epidural buprenorphine, morphine for postoperative analgesia,and the relationship between pruritus and analgesia effects

连硬外麻醉子宫切除６０例。随机分为丁组（丁丙诺啡组，ｎ＝３０）和吗组（吗啡组，ｎ＝３０）。术毕分别经导管一次性注入丁丙诺啡０．１５ｍｇ和吗啡２ｍｇ。术后比较两组间镇痛效果、不良反应和两组中出现与未出现瘙痒者的镇痛效果。结果：术后８，１２小时，丁组ＶＡＳ明显低于吗组（Ｐ＜０．０５）。至术后２４小时丁组才达到吗组８，１２小时水平。从本组资料分析丁丙诺啡０．１５ｍｇ的镇痛时间和不良反应均优于吗啡组，瘙痒与镇痛间似存在某种平行关系。

cases undergoing hysterectomy with epidural anesthesia were assigned randomly to receive either buprenorphine (n=30) or morphine (n=30) for postoperative epidural analgesia. At the end of operation buprenorphine 0.15mg or morphine 2mg were given respectively. Analgesia and side effects were assessed for the first 24hr. Pain was evaluated by patient using a Visual Analogue Scale.The effects of analgesia between the cases that accompanied with or without pruritus in both groups were observed too. The results showed that the VAS of group buprenorphine was significantly lower than group morphine at 8, 12hr after operation (P<0.05),and at 24hr the VAS of group buprenorphine had the same level as that group morphine at 8,12hr after operation. The observation implied that the analgesia effects of buprenophine 0.15mg is better than that of morphine 2mg while the side effect is less than that of morphine and there was certain relationship between pruritus and analgesia.