硬膜外吗啡持续注入用于小儿术后镇痛的研究

Effects of continuous epidural morphine for pediatric postoperative analgesia

目的 评价硬膜外吗啡 5μg· kg- 1 · h- 1 复合 0 .12 5 %丁哌卡因持续注入对儿童术后镇痛的效果及安全性。方法 选 ASA ( ～ )级择期腹部或下肢手术的患儿 2 3例 ,行硬膜外复合全麻 ,术毕以 0 .12 5 %丁哌卡因及吗啡 5μg· kg- 1 · h- 1 按 0 .5 ml· h- 1 的速率硬膜外腔持续注入 ,观察镇痛效果及副作用 ,监测血压、心率、呼吸频率及脉搏氧饱和度。结果 术后无痛及轻微痛的患儿 2 2 /2 3(95 .6 5 % ) ,中度痛 1/ 2 3(4.35 % ) ,血压、心率、呼吸频率稳定 ,无明显呼吸抑制 ,恶心、呕吐发生率较低 (分别为 17.39%、8.70 % )。结论 吗啡 5μg· kg- 1 · h- 1 复合 0 .12 5 %丁哌卡因硬膜外持续注入是儿童较为安全有效的术后镇痛方法之一。

Objective To evaluate the effects and safety of morphine combined with 0.125% bupivacaine continuous epidural injection for postoperative analgesia in pediatric patients.Methods Twenty three pediatric patients,ASA class Ⅰ Ⅱ, received selective abdominal or lower extremity surgery,and epidural combined with general anesthesia were performed.After operation 5μg·kg -1 ·h -1 morphine mixed with 0.125% bupivacaine was epidurally infused at the rate of 0.5 ml·h -1 ,the analgesic effect and side effects were recorded,blood pressure,heart rate,respiratory rate and pulse oxygen saturation were monitored.Results No pain and light pain rate was 22/23(95.65%),moderate pain rate was 1/23(4.35%). Blood pressure,heart rate and respiratory rate remained unchanged,no severe respiratory depression or other severe side effect occurred.Conclusion 5μg·kg -1 ·h -1 morphine mixed with 0.125% bupivacaine epidurally administered at the rate of 0.5 ml·h -1 is a safe and effective method for pediatric patient postoperative analgesia.