小儿硬膜外术后镇痛单次用药的可行性

The feasibility of epidural single dose of morphine and droperidol for postoperative pain in children

目的评价硬膜外吗啡复合氟哌利多单次注入对小儿术后镇痛的效果及安全性。方法选择择期腹部或下肢手术的患儿60例,随机分为A、B、C 3组,术毕A组硬膜外注入吗啡0.04～0.05mg/kg加入0.9%氯化钠10 ml,B组硬膜外给予吗啡0.04～0.05 mg/kg和氟哌利多0.03 mg/kg加入0.9%氯化钠10 ml,C组硬膜外给予吗啡负荷量20μg/kg后,以维持量2μg·kg^(-1)·h^(-1)持续注入,观察镇痛效果及副作用,术中监测血压、心率、呼吸频率及脉搏氧饱和度。结果3组间镇痛评分无统计学差异,但B组复合氟哌利多不良反应明显减少。结论硬膜外吗啡0.04～0.05 mg/kg复合氟哌利多0.03 mg/kg加入0.9%氯化钠10 ml单次注入是小儿术后简单、实用而又安全有效的镇痛方法之一。

Objective To study the effect and safety of single dose of epidural morphine and droperidol. Methods Sixty patients undergoing selective surgery were randomly assigned to A. B. C groups. A dose of morphine 0.04- 0.05 mg/kg and 0.9% Nacl 10 ml was given epidurally in group A at the end of surgery,morphine 0.04-0.05 mg/kg, droperidol 0.03 mg/kg and 0.9% Nacl 10 ml in group B. A loading dose of morphine 20μg/kg was given epidurally, then a continuous dose of morphine 2 μg/（ kg.h ） was given in group C The assessment of postoperative pain, sedation and adverse reactions was conducted at regular interals. Results Pain scores had no significant difference among the three groups, but the incidence of adverse reactions in group B was significantly lower than that in the other groups. Conclusion It is a simple and safe mothod for postoperative pain in children to give an epidural single dose of morphine 0.04-0.05 mg/kg,droperidol 0.03 mg/kg and 0.9% Nacl 10 ml for postoperative pain.