氯诺昔康联合硬膜外单次吗啡用于妇科术后镇痛的临床观察

Clinical Observation of Burnorphic Combining with Single Morphia Outputamen in the Easing Pain after Gynecology Surgery.

目的:评价不同剂量硬膜外单次吗啡联合氯诺昔康连续静脉输入应用于妇科全宫切除手术后镇痛的效果和安全性。方法:180例ASAⅠ-Ⅱ级在硬膜外阻滞麻醉下行妇科全宫切除手术的患者随机分为A、B、C 3组,每组均于手术结束时分别以吗啡(1 mg、1.5 mg、2 mg)注入硬膜外间隙,并用1次性静脉镇痛泵持续输注氯诺昔康(氯诺昔康32 mg+生理盐水至100 m l)。观察并记录术后4、8、16、20、24、32和48 h镇痛效果及不良反应。结果A、B、C 3组镇痛均满意,A组患者术后各时间点的VAS评分略高于B、C两组,但没有统计学意义(P>0.05);恶心呕吐、多汗等并发症发生率C组高于A、B两组(P<0.05)。结论:妇科全宫切除手术后氯诺昔康(32 mg)连续静脉输入联合硬膜外单次吗啡(1 mg、1.5 mg、2 mg)镇痛效果均满意,但不良反应发生率随着吗啡剂量增加而增加。

Objective： To evaluate the easing pain effect and security burnorphic combining single morpia outputamen after gynecology surgery. Methods： 180 cases of ASA Ⅰ -Ⅱ level gynecology surgery by outputamen anaesthesiawere divided into A , B and C groups randomly. They all were injected morphia （ （ 1、 1. 5、 2 mg） into outputamen clearance, and injected burnorphic by one - off easing pain pump （ burnorphic 32 mg added brine to 100 ml）. Abserved and noted effect and badness reaction in 4, 8, 16, 20, 24, 32, 48 h. Results. The results are satisfied in three groups. The VAS grade of A group is high than that of B and C groups, but no statistic meaning （P 〉 0. 05 ） . Nausea , vomit and excessive sweat ect. reccurence rate in C group is higher than that of A and B groups （P 〈 0. 05 ） . Conclusion： The effect is satisfacted, but the badness reaction is increasing with the increasing of morphia dosage.