小剂量咪唑安定治疗硬膜外吗啡所致瘙痒

Small Doses of Midazolam Relieve the Epidural Morphine-induced Pruritus

目的:研究小剂量咪唑安定在治疗硬膜外吗啡所致瘙痒的效果。方法:40例ASAⅠ～Ⅱ级、术后24h内瘙痒的患者随机分成两组,咪唑安定(M)组予静脉注射0.5mg咪唑安定;生理盐水(N)组静脉注射1mL生理盐水。如5min无效,重复使用相同剂量。瘙痒评分、镇痛评分、镇静评分每5min记录一次,记录30min。结果:M组有3例用药二次才有效,总有效率为85%,N组有效率为15%,两组比较有显著性差异(P<0.01)。结论:小剂量咪唑安定可以有效地治疗硬膜外吗啡所致的瘙痒。

Objective： To assess the influence of intravenous midazolam on the pruritus induced by epidural morphine. Methods： Forty cases, ASA physical status Ⅰ -Ⅱ , with spinal morphine-induced pruritus （in postoperative 24 h） were allocated to receive 0.5 mg midazolam or 1 mL saline intravenously. In the absence of a positive response, a second drug treatment was given 5 min later. Pruritus, sedative and the level of postoperative pain were assessed every 5 min up to the end of the study period （30 min）. Results： In M group 3 patients received a second drug treatment, the overall success rate was significantly greater in M group （85 %） than in N group （15%）（P 〈 0.01）. Conclusion： Midazolam in a small dose is an efficient drug treatment for spinal morphine-induced pruritus.