小儿术后硬膜外持续输注吗啡的镇痛效果观察

OBSERVATIONS OF ANALGESIA EFFECT FOR CHILDREN WITH CONTINUED EPIDURAL DRIPPING MORPHINE AFTER OPERATION

目的 :探索小儿硬膜外持续输注吗啡术后镇痛的有效剂量及并发症。方法 :选择ASAI～Ⅱ级择期腹部、尿道及下肢手术行硬膜外复合全麻患儿32例 ,随机分为3组。术毕前60min于硬膜外腔注入30μg/kg吗啡 ,术后镇痛维持量分别为 :组1为1μg·kg-1·h-1 ,组2为1.5μg·kg-1·h-1,组3为2μg·kg-1·h-1。观察镇痛效果及不良反应。结果 :镇痛评分组2、3明显低于组1 ,组3恶心、呕吐、搔痒、呼吸抑制发生率明显高于组1、2。结论 :负荷量30μg/kg,维持量1.5μg·kg-1·h

Objective: To investigate the effective doses of analgesia and complications with continued dropping morphine after operation in pediatric patients. Method: 32 cases of ASA Ⅰ～Ⅱpediatric patients undergoing abdominal, urinal and low limbs surgeries were randomly divided into three groups. All groups were injected 30 μg/kg morphine into epidural just 60 minutes before finishing the operation, then the maintaining doses of post-operation were giving 1 μg·kg-1·h-1,1.5 μg·kg-1·h-1 and 2 μg·kg-1·h-1 to group 1,2 and 3 respectively. Analgesia effects and complications were observed. Results: pain scores were obviously lower in group2 and 3 than group 1; group 3 had higher complication rate of nausea, vomit and scratch than group 1 and 2. Conclusions: loading dose of 30 μg/kg with maintaining dose of 1.5 μg/kg are safe doses and have lower complications for children's post-operation.