吗啡/芬太尼一次性硬膜镇痛效果观察

目的观察芬太尼在硬膜外腔一次注药后的镇痛作用和用药后尿潴留并发症。方法（1）371例硬膜外腔穿刺节段为T8～T10的患者随机分为A（芬太尼）组、B（吗啡）组和C（无镇痛）组;（2）521例硬膜外腔穿刺节段为T12～L3的患者分为a（芬太尼）组、b（吗啡）组和c（无镇痛）组。于术后4.5h、6.5h分别比较疼痛程度,术后6.5h比较尿潴留情况。结果3组（A、B、C组或a、b、c组）疼痛、尿潴留差异有统计学意义（P〈0.05）。疼痛在4h时A、B组（或a、b组）差异无统计学意义（P〉0.05）;疼痛、尿潴留在6.5h时A组与B组（或a组与b组）差异均有统计学意义（P〈0.05）。结论应用苏太尼、吗啡在4.5h内时镇痛无差异,随着时间延长,芬太尼镇痛作与吗啡相比镇痛作用减弱,在6.5h时芬太尼的尿潴留发生率少于吗啡,在临床镇痛时要辩证镇痛时间和尿潴留统一。

Observation of efficacy of epidural be analgesiad by morphine/fentanyl

Objective Obeserved the effect of analgesic after an injection in opidaral by fentanyl and complications of urinary retention after treatment. Methods （ 1 ） 371 patients with in epidural puncture segment of T8-T10 were randomly divided into A（fentanyl） group,B（morphine） group and C（no analgesia） group;（2） 521 cases of epidural puncture segment of T12 - L3 of the patients were divided into a（fentanyl） group ,b（morphine） group and e（ no analgesia） group. In the postoperative 4.5 hours,6.5 hours and compared pain levels, compared urosehesis at postoperative 6.5 hours. Results The difference of pain and uroschesis of these three groups （ A, B, C group, or a, b, c group） was statistically significant （P 〈 0.05 ）. When postoperative 4 hours, compared the pain of A, B group （ or a, b group） has no significant difference （ P 〉 0.05 ）. When after 6. 5 hours, compared the pain and uroschesis of group A and B （or a and b group） ,the differences were statistically significant （P 〈 0.05 ）. Conclusion Applicationof fentanyl and morphine, within 4. 5 hours, the analgesic was no difference. With the prolonged,fentanyl for analgesia was decreased in comparison with the morphine, and the incidence rate of uroschesis at 6.5 hours was less than that under morphine. When analgesised in clinical, the time of analgesia and urosehesis should be dialectical unity.