三种阿片类药物用于硬膜外术后镇痛效果的比较

目的比较吗啡、舒芬太尼及地佐辛硬膜外自控镇痛（patient-controlled epidural analgesia,PCEA）的效果,探讨取代吗啡的镇痛药物组合。方法选择手术患者120例,随机分为三组,每组40例。吗啡组：吗啡5 mg＋罗哌卡因200 mg＋生理盐水至100 mL;舒芬太尼组：舒芬太尼50μg＋罗哌卡因200 mg＋生理盐水至100 mL;地佐辛组：地佐辛5 mg＋罗哌卡因200 mg＋生理盐水至100 mL。观察24 h内镇痛效果及副作用的发生情况。结果三组术后PCEA镇痛满意度及24 h内各时点VAS评分比较差异无统计学意义（P〉0.05）。24 h内吗啡组恶心、呕吐、皮肤瘙痒的发生率明显高于地佐辛组（P〈0.05）。结论地佐辛用于PCEA镇痛效果好,副作用少,可以替代吗啡。

Comparison of three kinds of opioid drugs in postoperative patient-controlled epidural analgesia

Objective To compare the analgesic effects of Morphine,Sufentanil and Dezocine in patient-controlled epidural analgesia（PCEA）,and to explore which analgesic combination can be substitute for Morphine.Methods 120 patients underwent operation were randomly divided into three groups,with 40 cases in each group.Morphine group： Morphine 5 mg＋Ropivacaine 200 mg＋Sodium Chloride to 100 mL;Sufentanil group： Sufentanil 50 μg＋Ropivacaine 200 mg＋Sodium Chloride to 100 mL;Dezocine group： Dezocine 5 mg＋Ropivacaine 200 mg＋Sodium Chloride to 100 mL.The analgesic effects and side effects in 24 h were observed.Results The PCEA analgesic satisfaction and VAS scores in 24 h were of no significant differenct among the three groups（P 0.05）.The incidence of side effects in Morphine group was significant higher than that in Dezocine group（P 0.05）.Conclusion The analgesia effect of Dezocine for postoperative PCEA is good.Morphine can be substituted for Dezocine which induce less side effects.