中下腹部手术后硬膜外单次注射吗啡镇痛观察

Epidural Analgesia with Single Dose of Morphine Following Middle and Lower Abdominal Surgery

:[目的]探讨不同麻醉方法下术后单次注射吗啡镇痛的效应。[方法]中下腹部手术60例 ,分为27例硬膜外麻醉复合全身麻醉组(复合组)和33例单纯硬膜外麻醉组(单纯硬麻组) ,于术毕时经硬膜外导管注射吗啡1mg～1 5mg。观察镇痛效果与并发症。[结果]复合组优良率达96 3 % ,单纯硬麻组达87 8% ;并发症的发生率 ,复合组出现恶心呕吐为7 4 %、瘙痒为25 9 % ,单纯硬麻组出现恶心为18 2%、呕吐为9 1 %、瘙痒为9 1% ,两组比较无统计学差异。未发现有呼吸抑制。镇静评分均为1分。[结论]硬膜外注射小剂量吗啡对中下腹部手术可产生良好的术后镇痛效果 ,但可出现一定的并发症。全麻复合硬膜外麻醉效果更佳 。

To investigate the effect of postoperative epidural analgesia with single dose of morphine in varous anesthesias.Sixty cases of middle and lower abdominal surgery were randomized divided into two groups:epidural combined with general anesthesia (group 1,n=27) and epidural anesthesia only (group 2,n=33).Once the operation finished,morphine 1mg～1 5mg was injected through epidural catheter.The analgesic effects were observed as well as the complications.The excellent and good effect in group 1 were 96 3%,compared to 87 8% in group 2.The incidence of nausea or vomiting in group 1 was 7 4% and pruritus was 25 9%,whereas nausea,vomiting and pruritus in group 2 were 18 2%,9 1% and 9 1% respectively.No significant difference was found between two groups.The score of sedation was both grade one.[Conclusion]Epidural analgesia with single small dose of morphine can cause excellent analgesic effect following middle and lower abdominal surgery,but it can result in some complications.Epidural combined general anesthesia can get more excellent analgesic effects with less complications.