摘要
目的 比较硬膜外吗啡和氟哌利多超前镇痛与术后镇痛的临床效果和安全性。方法选择ASAⅠ～Ⅱ级 ,年龄 37～ 4 9岁 ,择期在硬膜外麻醉下行妇科手术的患者 30例 ,随机分为超前镇痛组 (Ⅰ组 )和术后镇痛组 (Ⅱ组 ) ,每组 15例。Ⅰ组在术前 2 0min经硬膜外导管一次性注入吗啡2 0mg和氟哌利多 1 2 5mg ;Ⅱ组在术毕即硬膜外注入上述等量药物。术后 2、4、8、12、2 4h随访并记录镇痛效果、镇静程度及不良反应 ,监测血压、心率、呼吸频率、脉搏血氧饱和度 ;术中记录局麻药用量。结果 超前镇痛组术后 8～ 2 4h镇痛效果优于术后镇痛组 ,且局麻药用量减少。
Objective To compare the efficacy and safety of morphine and droperidol for preemptive analgesia with traditional postoperative pain relief.Methods 30 ASA physical status Ⅰ Ⅱ patients scheduled for selective gynecological procedures were randomly assigned to two groups:preemptive analgesia group (group Ⅰ, n= 15)and postoperative analgesia group (group Ⅱ, n= 15).In group Ⅰ,single bolus of morphine 2mg and droperidol 1 25mg in normal saline was injected epiduraly 20minutes before local anesthetic administration.In group Ⅱ,the same dose of drugs as in group Ⅰ was given immediately at the end of surgery.The consumption of local anesthetics was recorded during the operation.The patients were followed up at 2,4,8,12,24 h after operation.Pain was assessed using visual analog scales (VAS) and sedation score was graded by 4 point rank drowsiness score.Postoperative mobilization was quantified with 4 graded mobilization scale.The side effects,heart rate,blood pressure,SpO 2,and respiratory rate were recorded.Results The amount of anesthetics in the group Ⅰ was significantly lower than that in group Ⅱ( P< 0 05).VAS was significantly lower in group Ⅰ than that in group Ⅱ at 8h after surgery( P< 0 05).Sedation scores of two groups were not different.Blood pressure,heart rate,SpO 2 and respiratory rate in two groups remaimed unchanged.Conclusion Preemptive epidural morphine 2 0mg with droperidol 1 25mg has a better analgesic effect than postoperative pain relief tachnic with same drugs.
出处
《临床麻醉学杂志》
CAS
CSCD
2003年第8期473-474,共2页
Journal of Clinical Anesthesiology
