摘要
目的：探讨硬膜外腔持续泵注阿片类激动剂术后镇痛效果和并发症发生率．方法：选食道癌或贲门癌切除术后患者６２例，随机给予浓度为１０ｍｇ／Ｌ芬太尼（ｎ＝３２）或等镇痛强度浓度０．１ｇ／Ｌ吗啡（ｎ＝３０），两者均与１ｇ／Ｌ布比卡因相加，泵注速度为５ｍＬ／ｈ．结果：两组间术后镇痛效果相似，无统计学意义．但芬太尼组所致恶心呕吐（６．３％），皮肤瘙痒（２２％）以及嗜睡（３％）之发生率明显较吗啡组发生率（１３％，４０％，１０％）为低（Ｐ＜０．０１）．两者均可维持稳定的血流动力学，呼吸次数维持在（１６±３）次／分，脉搏氧饱和度（ＳｐＯ２）维持在（９６±２）％，无一例发生呼吸抑制．结论：持续泵入芬太尼术后镇痛较吗啡更具优势，与单剂量推注比较而言，持续泵注可较好维持术后镇痛效果．
AIM: To evaluate the effects and the side effects rate of epidural opioids drug after continuous infusion. METHODS: The study was randomized to observe postoperative epidural infusions at 5 mL/h, fentanyl 10 mg/mL ( n =32) and morphine 0.1 mg/mL ( n =30), both with 1 g/L bupivacaine, in patients having esophagetomy or esophagojejunostomy. RESULTS: The degree of analgesia achieved was similarly satisfactory in all patients in both groups. There were no significant differences between the two groups. The incidence of nausea, vomiting, pruritis and sedation was significantly lower in the fentanyl group as compared with that of the morphine group ( P <0.01).Both groups remained stable hemodymanically and no respiratory depression developed, with respiratory rate being 16±3b pm and SpO 2 96%±2%. CONCLUSION: The epidural infusion of fentanyl has significant advantages over epidural morphine for relief of postoperative analgia. The continuous infusion technique also obviates the need for repetitive bolus injections, and provides a contstant level of analgesia.
出处
《第四军医大学学报》
1999年第4期354-356,共3页
Journal of the Fourth Military Medical University
关键词
疼痛
术后镇痛
硬膜外腔
芬太尼
吗啡
pain
postoperative
analgesic techniques
epidural fentanyl
morphine
