吗啡超前镇痛对阑尾手术内脏牵拉痛的影响

目的探讨吗啡硬膜外超前镇痛对抑制阑尾手术内脏牵拉痛及术后镇痛情况的影响。方法 40例ASAⅠ～Ⅱ级急、慢性阑尾炎患者,均于硬膜外麻醉下行阑尾切除术。将其随机分为两组,每组20例,即Ⅰ组（对照组）：术前不施行超前镇痛;Ⅱ组（实验组）：切皮前10 min将吗啡1.5 mg加入利多卡因注入硬膜外腔。所有患者均不行术后镇痛。观察两组患者术中牵拉反应、术后疼痛情况及并发症。结果Ⅱ组抑制术中牵拉痛的效果明显优于I组（P〈0.05）;Ⅱ组首次出现疼痛时间较Ⅰ组显著延长（P〈0.01）,Ⅱ组术后尿潴留患者多于Ⅰ组（P〈0.01）。结论吗啡硬膜外超前镇痛能明显抑制术中牵拉痛,提供良好的术后镇痛效果,减少阿片类药物的用量。

Effects of morphine in preemptive analgesia on visceral referred pain in appendectomy

Objective To study the effects of morphine in preemptive analgesia on visceral referred pain and on pain relief after operation.Methods Forty ASA Ⅰ-Ⅱ patients undergoing selective appendectomy under sepidural anesthesia were randomly divided into two groups.Group Ⅰ(control group)did not receive preemptive analgesia(n=20),and group Ⅱ(experiment group)received epidurally morphine 1.5 mg added ten minutes before skin incision(n=20).The operative referred pain,postoperative analgesia effects and complications were observed.Results The referred pain in operation was inhibited markedly in group Ⅱmore than that in group Ⅰ(P<0.05).The time of first pressing by the patients in groupⅡ was longer than that in group Ⅰ(P<0.01).Clog of emiction was more in group Ⅱ than that in group Ⅰ(P<0.01).There was no significant difference of the other postoperative complications between the two groups.Conclusion morphine in preemptive analgesia can obviously inhibit operative referred pain,provide adequate pain relief after operation,and reduce opiate drug consumption.