盐酸戊乙奎醚联合氟哌利多降低吗啡硬膜外术后镇痛的不良反应

Penehyclidine hydrochloride combined with droperidol reduces postoperative side effects during epidural analgesia with morphine

目的观察盐酸戊乙奎醚联合氟哌利多对吗啡用于硬膜外术后镇痛不良反应发病率的影响。方法连续硬膜外麻醉行子宫下段剖宫产手术的患者96例,ASAⅠ或Ⅱ级,随机分为单纯吗啡组(A组)、吗啡+氟哌利多组(B组)、吗啡+盐酸戊乙奎醚组(C组)及吗啡+盐酸戊乙奎醚+氟哌利多组(D组),每组24例。术毕5min分别将各组吗啡混合液各自注入硬膜外腔后拔出硬膜外导管回病房,记录术后镇痛效果及术后恶心呕吐(PONV)、皮肤瘙痒、尿潴留、口干等不良反应。结果D组的镇痛效果明显优于A、B、C组(P<0.01),且PONV、皮肤瘙痒等不良反应发病率明显低于A、B、C组(P<0.05)。结论盐酸戊乙奎醚联合氟哌利多可明显降低吗啡用于硬膜外术后镇痛不良反应的发病率。

Objective To study the effect of penehyclidine hydrochloride combined with droperidol on the side effects of morphine postoperative epidural analgesia. Methods Ninely-six ASA classⅠ or Ⅱ patients received epidural anesthesia after caesarean section were divided randomly into four groups with 24 cases each. Single bolus of morphine 2 mg in normal saline in group A, single bolus of morphine 2 mg and droperidol 2 mg in normal saline in group B,single bolus of morphine 2 mg and penehyclidine hydrochloride lmg in normal saline in group C and single bolus of morphine 2 mg and penehyclidine hydrochloride 1 mg and droperidol 2 mg in normal saline in group D were injected into epidural space within 5 min after operation. Analgesic efficacy and side effects were observed and recorded during postoperative analgesia. Results Analgesic efficacy in group D was significantly better than that in the other three groups （P〈0.01） . Side effects such as postoperative nausea and omitting skin pruritus, urinary retention and so on were significantly less in group D than those in the other three groups（P〈0.05）. Conclusion Penehyclidine hydrochloride combined with droperidol can signicantly reduce the frequency of postoperative side effects during eprdural analgesia with morphine.