吗啡、布比卡因及地塞米松配伍用于硬膜外术后镇痛的研究

Postoperative epidural analgesia with bupivacaine,morphine and dexasine after hysterectomy

目的 研究吗啡、布比卡因和地塞米松配伍用于硬膜外术后镇痛的时效。方法 ( 1)ASAⅠ～Ⅱ级择期子宫切除术患者 4 0例 ,按术后硬膜外用药的不同随机分为两组 ,每组 2 0例。Ⅰ组(研究组 )术后硬膜外用药为 0 5 %布比卡因 3ml+吗啡 2mg +地塞米松 10mg ,Ⅱ组 (对照组 )术后硬膜外用药为 0 5 %布比卡因 3ml+地塞米松 10mg。记录两组患者术后 ( 72小时内 )主诉手术部位出现疼痛和下肢运动功能恢复的时间 ,以及不良反应恶心呕吐及瘙痒等症状的发生率。 ( 2 )测定 0 5 %布比卡因溶液、吗啡溶液、地塞米松溶液和三种药物配伍后混合溶液的粘度。结果 ( 1)Ⅰ组术后无痛状态的持续时间均超过 72小时 ,显著长于Ⅱ组 ,两组下肢运动功能恢复的时间无显著差异 ,Ⅰ组术后恶心呕吐发生率显著高于Ⅱ组 ,所有病例术后均未发生瘙痒 ,呼吸与循环功能平稳。 ( 2 )吗啡溶液和 0 5 %布比卡因溶液的粘度显著小于地塞米松溶液和此三种药物配伍后混合液的粘度。结论 吗啡、布比卡因和地塞米松配伍硬膜外应用可获得良好和持久的术后镇痛效果。

Objective To study the analgesic duration of epidural analgesia with bupivacaine,morphine and dexasine after hysterectomy.Methods In a randomized study,40 patients undergoing elective hysterectomy were assigned into group Ⅰ and Ⅱ.In group Ⅰ,0 5% bupivacaine 3ml and morphine 2mg in combination with dexasine 10mg test solutions were injected to epidural space.In group Ⅱ,0 5% bupivacaine 3ml with dexasine 10mg(control group)were used.Meanwhile,the viscositys of 0 5% bupivacaine solution,morphine solution and dexasine solution,as well as the test solution was measured.Results The postoperative analgesic duration of Group Ⅰ wsa significantly longer than that of Group Ⅱ.The viscositys of dexasine solution and bupivacaine and morphine in combination with dexasine solution were significantly higher than that of 0 5% bupivacaine solution and morphine solution.Conclusion The combination of bupivacaine,morphine and dexasine may produce a longer postoperative analgesic duration.