摘要
目的:探讨硬膜外腔应用新斯的明(Neo)、吗啡(Mor)的术后镇痛效果和副作用.方法:选择腹部手术患者116例,随机分成5组.N1组:Neo 1mg,N2组:Neo 2mg,M1组;Mor 1 mg,M2组:Mor 2mg,M1+N1组:Mor 1mg+Neo 1mg,于术毕注入硬膜外腔.结果:镇痛时间N1组明显小于其余4组(P<0.01),M1,M2和M1+N1组作用时间相近;N1组镇痛效果优、良、差的比率分别为0,54.5%,45.6%,M2和M1+N1组的优、良率均为100%,N2组为83.3%;首次应用镇痛药时间M1,M2和M1+N1组相近.且较N1,N2组延迟,恶心呕吐发生率N1,N2和M1+N1组相近,均明显低于M1,M2组;尿潴留发生率M2组最高,为51.2%,N1,N2组为0;N2组出现1例心动过缓和2例大便失禁.结论:硬膜外腔应用新斯的明可产生依赖性镇痛作用延长,Neo 2mg镇痛效果确切;与Mor伍用有协同效应,副作用减少.
To compare the analgesic and side effects of post-operative analgesia with epidural neostigmine (Neo), morphine (Mor) or both in patients underwent abdominal surgery. Methods: Elective abdominal surgery was performed in 116 patients. They were randomly divided into five groups at the end of the surgical procedure. Group N1(n=11) and N2(n=15) were administered epidurally with Neo 1 mg and 2 mg respectively,Group M1(n=18) and M2 (n=55) were administered epidurally with Mor 1 mg and 2 mg respectively,Group M1+N2(n=17) was administered epidurally both Mor 1 mg and Neo 1 mg. Results: Single epidural administration of Neo (1 mg or 2 mg) or Mor (1 mg or 2 mg)showed a dose-dependent analgesic effects. The analgesic duration in Group N1 was (4. 7±2. 7) h,were significantly shorter than other four groups(P<0. 01). Group M1,M2 and M1+N1 showed better analgesic effects than group Nl and N2. with similar analygesic durations. The percentages of excellent,good and poor effects were 0,54. 5% and 45. 6% respectively in group N1. The percentages of excellent and good effects were both 100% in group M2 and M1+N1,but only 83. 3% in group N2. The time to first rescue analgesic medication was similar in group M1,M2 and M1+N1,but longer compared with group N1 and N2. The incidences of nausea and vomiting were similar in group N1,N2 and M1+ N1,which were less than that in group M1 and M2. The incidence of urine retension was 51. 2%, 27. 8% and 29. 4% in group M2.M1 and M1+N1 respectively,but 0% in group N1 and N2. In group N2 two patients opened the bowel movement and one patient developed bradycardia (48 beats/min) at 45 min after received Neo and resolved without atropine. Conclusion: Epidural Neo produces a dose-dependent prolonged analgesic effects (similar to Mor). The combination of Mor and Neo can produce analgesia with fewer side effects than administration of equivalent analgesic doses of each drug solely. The epidural Neo 2 mg can provide satisfactory postoperative analgesia.
出处
《第四军医大学学报》
1998年第2期216-218,共3页
Journal of the Fourth Military Medical University
关键词
硬膜外腔
镇痛
新斯的明
量效关系
epidural analgesia neostigmine morphine dose-effect relation
