摘要
２００例ＡＳＡⅠ～Ⅱ级、年龄１８～４４岁、体重４５～６８ｋｇ的子宫或卵巢全部或部分切除的患者，以单盲法分为四组，每组５０例，分别于术后自硬膜外腔注入①吗啡２．５ｍｇ；②吗啡２．５ｍｇ＋中分子右旋糖酐６ｍｌ；③吗啡２．５ｍｇ＋纳洛酮０．４ｍｇ；④吗啡２ｍｇ＋５％ＮａＣ１６ｍｌ，比较了注药前及注药后１、３、６、９、１２ｈ的ＣＯ２通气反应、止痛效应及副作用。认为２．５ｍｇ吗啡有满意的止痛作用，但在１～１２ｈ尤其是３～９ｈ有中枢性呼吸抑制作用。右旋糖酐可能减慢吗啡自硬膜外腔向脑脊液的扩散，从而延长术后止痛时间，减轻吗啡的中枢呼吸抑制效应。０．４ｍｇ纳洛酮与２．５ｍｇ吗啡合用仍保留了止痛作用，在用药后１～３ｈ，中枢性呼吸抑制作用似有减轻。高渗盐水无明显的止痛作用，不能增强吗啡的止痛效应。
orphine 2mg and 5%NaCl solution,morphine 2. 5 mg and 6%dextran 70, morphine 2. 5 mg and naloxane0.4 mg were compared with morphine 2.5 mg alone for epidural analgesia in 200 patients undergoing electivesubtotal hysterectomy(ASA class Ⅰ～Ⅱ, aged 18～44 yr, weighing 45～68 kg). The CO2 responese curves weremeasured 30 min before and at 1,3,6,9, 12h after epidural administration of morphine mixtures。 Close monitoringof SpO2, respiratory rate, PETCO2 via nasal cannula was carried out for 12 h. Side effects and pain scores were ob-tained. The study show that epidural morphine 2.5 mg provided proper postoperative analgesia and prolonged de-pression of central respiratory regulation, The depression peaked within 3～9hafter administration. Morphine 2.5mg and 6%dextran 70 resulted in a longer pain relief while central respiratory depression was dimished. It sug-gests that the dextran molecular absorbed some morphine and then morphine penetrated through the dura to reachspinal fluid more slowly. Morphlne 2mg and 5%NaCl failed to improve analgesia. Epidural naloxane 0.4mgseemed to increase the slope of CO2 respones curve for 1～6h,but this was only significant at 1 and 3 h.This doseof naloxane did not affect analgesic effect of morpnine.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
1995年第6期326-329,共4页
Journal of Clinical Anesthesiology
