加巴喷丁预防腰麻时鞘内注射吗啡引起瘙痒的临床观察

目的：观察加巴喷丁预防腰麻时鞘内注射吗啡引起瘙痒的效果.方法：选择80例在腰麻下行下肢骨科手术患者,随机分成加巴喷丁组（G组,手术前2 h口服加巴喷丁400 mg）和对照组（C组,无术前用药）,所有患者均鞘内0.5%等比重布比卡因15 mg和吗啡0.2 mg.观察两组患者给予吗啡后2,4,8,12,24 h的瘙痒程度,记录两组患者瘙痒发生率、瘙痒出现时间、持续时间.结果：G组、C组患者瘙痒的发生率分别是47.5%和77.5%,差异有统计学意义（P＜0.05）;瘙痒出现时间分别是（6.1±1.4）h和（2.8±0.7）h,差异有统计学意义（P＜0.05）;与G组相比,C组在注射吗啡后2,4,8 h时间点的瘙痒程度显著增加（P＞0.05或0.01）.在注射后12,24 h差异无统计学意义（P＆gt;0.05）.结论：腰麻时给予0.5%等比重布比卡因15 mg和吗啡0.2 mg行下肢骨科手术前口服加巴喷丁400 mg可以降低瘙痒的发生率、减轻瘙痒程度、延迟瘙痒的起始时间.

Prophylactic Effects of Gabapentin on Itching Induced by Intrathecal Injection of Morphine in Lumbar Anesthetic Patients

Objective ： To investigate the prophylactic effects of gabapentin on itching induced by intrathecal injection of morphine in lumbar anesthetic patients. Methods： Eighty patients who received lumbar anesthesia and orthopedic surgery on lower limbs were enrolled. The patients were randomly divided into gabapentin group （ G group） and the control group （ C group）. The G group was giv- en gabapentin （400 rag） orally 2 h before the surgery, while no pre-surgery drug was used in the C group. The degree of itching in both groups was investigated at 2, 4, 8, 12 and 24 h after the morphine treatment. The incidence, latency and duration of itching were recorded. Results： The incidence of itching in the G group was significantly lower than that of the C group （47.5% v.s. 77.5% , P 〈 0.05 ）. The latency of itching in the G group （ 6.1 ± 1.4 ） h was prolonged compared with that in the C group （ 2, 8 ± 0.7 h, P 〈 0.05 ）. Compared with that in the C group, the degree of itching in the G group was markedly decreased at 2, 4 and 8 h after the mor- phine use （ P 〈 0.05 or 0.01 ）. However, no significant difference in the degree of itching was observed between the two groups at 12 and 24 h after the morphine treatment （ P 〉 0.05 ）. Conclusion ： Gabapentin （400 mg） orally administrated 2 h before lumbar anesthe- sia and orthopedic surgery on lower limbs can reduce the itching induced by intrathecal injection of morphine in lumbar anesthetic pa- tients.