东莨菪碱预防吗啡、布比卡因持续硬膜外镇痛副作用的临床观察  

A Clinical Observation on Scopolamine as a Medicine Preventing the Side Effects of Morphine and Bupivacaine in Continuous Epidural Analgesia

作　　者：方建国 戴德坚[2] 孟化[2] 高翔 于志坚 

机构地区：[1]武汉市江夏区第一人民医院麻醉科,武汉430200 [2]浙江大学医学院附属第二医院普外科,杭州310009

出　　处：《中国药物滥用防治杂志》2004年第3期133-135,共3页Chinese Journal of Drug Abuse Prevention and Treatment

摘　　要：目的:评价东莨菪碱预防上腹部手术后吗啡、布比卡因持续硬膜外镇痛副作用的优越性。方法:前瞻性设计,对上腹部手术ASA评分为Ⅰ～Ⅱ级者分二组,Ⅰ组(吗啡6 mg + 布比卡因0.125 g + 东莨菪碱2.4 mg),Ⅱ组(吗啡6 mg+布比卡因0.125 g),均在术后持续硬膜外镇痛泵给药。对吗啡、布比卡因镇痛效果及副作用发生率进行统计分析。结果:Ⅰ组VAS值为0.68,满意率为95.78%;Ⅱ组VAS值为1.62,满意率为86.27%,有显著性差异(P<0.01)。恶心呕吐、多汗、尿潴留发生率Ⅰ组明显低于Ⅱ组,有显著性差异(P<0.05)。嗜睡发生率两组相比无显著差别,且两组均未观察到呼吸抑制。结论:东莨菪碱不仅能增强镇痛效果、提高镇痛的满意率,而且能预防镇痛剂的副作用,为临床镇痛治疗提供新方法。Objective: To evaluate the advantages of scopolamine as a medicine preventing the side effects of morphine and bupivacaine in continuous epidural analgesia. Methods: The patients with epigastric operations (ASA Ⅰ- II) were divided into two groups. Group I (morphine: 6mg + bupivacaine:0.125g + scopolamine:2.4mg ) and group II (morphine: 6mg + bupivacaine:0.125 g) were administrated by continuous epidural Batex pump. Statistical analysis was applied to evaluate analgesic effect or incidence rate of side effects in two groups tested. Results: VAS value and satisfactory rate of the group I were 0.68 and 95.78% respectively whereas those of the group II were 1.62 and 86.27% respectively. A significant difference was found between two groups (P <0.01). Incidence rates of nausea, emesis, profuse sweating and uroschesis in group I were significantly lower than those in group II (P <0.05). In incidence rate of lethargy, no remarkable deference was identified between two groups. Respiratory depression was not observed in both of them. Conclusion: Scopolamine not only improves analgesic effect and satisfactory rate, but also prevents the side effects of anodyne and provided new way for clinical analgesic therapy.

关 键 词：东莨菪碱 预防措施 吗啡 布比卡因 持续硬膜外镇痛 副作用 镇痛作用 

分 类 号：R614[医药卫生—麻醉学]