恩丹西酮复合纳络酮预防硬膜外吗啡副作用的临床观察

Clinical observation of prevention of morphine's adverse effect during epidural analgesia by ondansetron combined with nalo-xone

目的 :观察恩丹西酮、纳络酮联合用药预防硬膜外吗啡镇痛引起的副作用的临床疗效。方法 :选择 80例妇科手术病人随机分为 3组 :A组为对照组 ,B组为恩丹西酮组 ,C组为纳络酮组 ,D组为恩丹西酮复合纳络酮组。所有病人在手术后接受硬膜外吗啡镇痛 ,B、D两组病人在术毕静推恩丹西酮 8mg,C、D两组病人在硬膜外用吗啡的同时加用纳络酮 0 .4mg。结果 :四组病人 48h内镇痛效果无显著性差异 ;B、C、D三组病人术后恶心呕吐 ,皮肤瘙痒发生率与A组相比较有显著性差异(P <0 .0 5 ) ,尤其D组特别明显 ;C、D组尿潴留发生率与A、B两组比较有非常显著性差异 (P <0 .0 1 )。结论 :恩丹西酮与纳络酮联合用药 ,在不改变术后吗啡镇痛效果的同时 。

Objective: We have observed the clinical effect of ondan-setron combined with naloxone on preventing the adverse effect of epidural morphine analgesia. Methods: Eight gynecological patients scheduled for selective operation were assigned into four groups: group I (the control group, no ondansetron and naloxone), group II (ondansetron group), group III (naloxone group), group IV (ondansetron combined with naloxone group). We used epidural morphine analgesia on all patients after operation. In group II and IV, we used 8 mg ondansetron intravenously after operation, in group III and IV we used 0.4 mg naloxone additionally. Results: All patients of four groups have no significant difference in analgesic effect. Compared with group I, patients of group II ,III and IV had significantly reduced postoperative nausea , vomiting, and itch of skin(P<0.05),while among group IV , group II and III there was no significant difference.Compared with the other two groups, patients of group III and IV had lower morbidity of urinal retention (P<0.01). Conclusions: Ondansetron combined with naloxone could control the adverse effect effectively, while no effect on analgesic effect.