三种不同剂量的吗啡硬膜外持续输注用于术后镇痛临床观察

观察了术后硬膜外腔应用３ 种不同剂量的吗啡和０．６２５ ｇ／Ｌ布比卡因混合液， 持续输注对镇痛效果和副反应的影响。以视觉模拟标定法 （ＶＡＳ） 评分观察镇痛效果并记录２４ ｈ 副反应。结果３ 组镇痛效果无显著性差异， ２４ ｈＶＡＳ评分各点均＜ ３ 分。恶心、呕吐发生率随吗啡剂量增大而增加。３ 组与１ 组比较有显著性差异 （Ｐ＜ ０．０５， Ｐ＜０．０１）。术后肛门排气时间３组间均无显著差异。结果表明： 硬膜外持续输注小剂量吗啡（≤０．０６７ ｍ ｇ／ｈ） 术后镇痛， 安全、可靠， 镇痛水平衡定。恶心、呕吐发生率与剂量相关。３组肛门排气时间无显著性差异， 可能与局麻药的联合应用及吗啡剂量较小有关

Clinical Observation on the Postoperative Analgesia of Morphine with Three Doses by Continuous Epidural Space Perfusion

The analgesic and side effects ofthe m ixture of0.625 g/Lbupivacaine w ith m orphine w ith three doses in the patients receiving continuous epidural analgesia after hysterectom y or cesarean section w ere observed. The visualanalgesic pain scores in 24 h w ere allbelow 3 and the differences am ong the 3 groups w ere notsignificant. The incidence ofnausea and vom iting w asrelated to the dose ofm orphine used and itw as significantly higher in group 3 than in group one (P< 0.05, P< 0.01) . No difference in flatus tim e after operation w as found am ong the 3 groups. The resultindicated thatcontinuous epiduralinfusion of low dose ofm orphine (< 0.067 m g/h) obtained a good analgesia and low er side effects. The incidence of nausea and vom iting w as related to the dose of m orphine used. No significant difference w as found in flatus tim e am ong the three groups, w hich m ightbe related to the com bined use oflocalanaesthesitics and low dose of m orphine.