小剂量吗啡-红细胞载体在不同年龄脊柱矫形术后的应用

To use red blood cell entrapped morphine (RBC-M) in patients undergoing scoliosis correction surgery

目的 了解吗啡 红细胞载体 (RBC M)在不同年龄组患者脊柱矫形手术后的镇痛效果。方法 随机选择ASAⅠ～Ⅲ级择期手术患者 6 0例 ,其中 ,观察组 4 5例 [按照年龄分为三组 ,儿童组 (A组 ) ,中青年组 (B组 ) ,老年组 (C组 ) ,各 15例 ,均于手术结束前 30min静注 0 12mg/kg的RBC M],儿童对照组 (D组 ) 15例 (于手术结束前 30min单纯静注吗啡 0 12mg/kg)。术后 8d内记录病人视觉模拟评分 (VAS)和Ramsay镇静评分 (RSS)以及并发症发生情况。结果 与A、B、C组相比 ,术后 6～ 8hD组RSS评分有显著升高 ,而VAS评分差异无显著性 ;6～ 8h后 ,与A、B、C组相比D组的RSS评分显著降低 ,VAS评分显著升高。术后 8d内 ,A、B、C组之间相比VAS、RSS评分差异无显著性。结论 吗啡 红细胞载体用于脊柱矫形手术患者的术后镇痛是有效的。由于具有较宽的安全年龄范围 。

Objective To use red blood cell entrapped morphine (RBC-M) in patients undergoing scoliosis correction surgery for postoperative analgesia.Methods According to different analgesic methods and patientsˊ ages,sixty patients(ASAⅠ-Ⅲ),undergoing scheduled scoliosis correction surgery enrolled the investigation,were divided into four groups(child group A, adult group B, aged group C and controlled child group D).During 30 minutes before the ending of the surgery, patients in group A, B and C received RBC-M 0.12 mg/kg IV respectively, while patients in group D received plain morphine 0.12mg/kg IV. VAS scores and RSS scores,as well as side effects and complications were recorded daily after the surgery.Results During the 6-8 hours after the surgery ,RSS scores are significantly higher in controlled child group than those in RBC-M groups,the VAS scores are not. Ensuing 6-8 hours,in controlled child group,VAS scores increased and RSS scores decreased significantly,but there wasnt significant change between RBC-M groups.Conclusion RBC-M can relieve pain effectively for patients having undergone scoliosis correction surgery.Furthermore,RBC-M can provide a wide safe age scope that it can safely be applied to patients, either children or the aged.