不同给药方式吗啡臂丛神经阻滞用于上肢术后镇痛的研究

Study of Postoperative Analgesia with Morphine in Brachial Plexus Block by Two Different Methods for Upper Extremity Surgery

目的:比较吗啡不同给药方式臂丛神经阻滞下上肢术后镇痛的效果。方法:72例ASAⅠ-Ⅱ级在肌间沟臂丛神经阻滞下实施上肢手术的患者,随机分为A、B两组,每组各36例。A组在局麻药内加吗啡3.5mg,B组术毕将吗啡3.5mg注入患侧肌间沟(锁骨中点上1.5cm处)行臂丛神经阻滞。观察两组术后镇痛效果及副作用。结果:A组综合镇痛质量优于B组,镇痛时间长于B组;A、B两组术后恶心发生率分别为13.9%和16.7%,皮肤瘙痒发生率分别为16.7%和19.4%,两组无显著性差异(P>0.05)。结论:将小剂量吗啡术前臂丛神经阻滞用于术后镇痛明显优于术后给药。

Objective：To evaluate the effects of postoperative analgesia with morphine in brachial plexus block by two different ways for upper extremity surgery. Methods ： 72 ASA Ⅰ - Ⅱpatients scheduled for upper extremity surgery under muscle sulcus brachial plexus block were divided randomly and evenly into two groups ,36 patients every group. 3.5 mg morphine was added into local anesthetic drugs in group A. 3.5 mg morphine was infused into brachial plexus nerves after surgery in group B. To observe the analgesia effect and the side effects. Results： The general analgesia quality of group A was superer than group B ,and the analgesia time was longer than group B（ P 〈0. 05 ） ; the rates of nausea of group A and B were respectively 13.9% and 16.7% ,the rates of skin itch were respectively 16. 7% and 19.4% ,there was no significant difference in two groups （ P 〉 0.05 ）. Conclusions ： The quahty of postoperative analgesia using small dosage of morphine brachial plexus neuraxial blocking before surgery is superer obviously than injection of morphine into brachial plexus nerves after surgery.