吗啡和芬太尼用于小儿术后静脉镇痛的临床研究  

Comparison of morphine and fentanyl venous infusion for the treatment of acute pain in children

作　　者：毕素萍[1] 张宏[1] 李文广[1] 

机构地区：[1]解放军总医院麻醉科,北京100853

出　　处：《军医进修学院学报》2005年第3期222-224,共3页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的:探索吗啡和芬太尼用于小儿术后静脉镇痛的最佳可行性方案。方法:择期行手术患儿40例,按区组随机化分成吗啡组、吗啡+芬太尼组,每组20例。气管插管全身麻醉,于术毕接通持续背景量止痛泵。吗啡组:吗啡按700μg·kg1加生理盐水配成50ml,持续背景速度是1ml·h1。吗啡+芬太尼组:吗啡按450μg·kg1,芬太尼按4.5μg·kg1,加生理盐水配成50ml,持续背景速度同上。于0h、2h、4h、8h、12h、24h、48h记录下列指标:疼痛评分、镇静评分;恶心、呕吐等副作用。结果:镇痛、镇静效果两组无显著性差异(P>0.05)。吗啡组1例出现过度镇静。两组恶心、呕吐的发生率无明显差异(P>0.05)。结论:单纯吗啡14μg·kg1h1或吗啡与芬太尼1∶1混合,吗啡9μg·kg1·h1加上芬太尼0.09μg·kg1·h1背景量输注镇痛均取得良好效果,值得临床推广。Objective:To explore the best regimens which relieve children's acute pain. Methods:Forty children were allocated randomly to receive one of two analgesic regimens.All patients received a standard general anaesthesia. In group M the solution used consisted of morphine 700μg·kg^(-1) diluted in 50ml of 0.9% saline. In group M+F the solution used consisted of morphine 450μg·kg^(-1 ) and fentanyl 4.5μg·kg^(-1 ).The background infusion was commenced at rate of 1ml·h^(-1 )in both groups. The infusions were started in the recovery area using Korean Accufuser pump. We measured pain score and sedation score at point of 0h, 2h, 4h, 8h, 12h, 24h, 48h. And episodes of nausea and vomit were recorded.Results:There were no significant differences in pain score and sedation score between the groups at any point. But excessive sedation (a score of 2) occurred in one patient in Group M. There were also no statistic differences in the incidence of nausea and vomiting. Conclusion:Purely morphine (14μg·kg)^(-1)·h^(-1) or morphine 9μg·kg^(-1)·h^(-1) mixed with fentanyl 0.09μg·kg^(-1)·h^(-1) continuous infusions are both effective on relieving children’s postoperative pain.

关 键 词：疼痛 手术疗法 镇痛作用 静脉镇痛 小儿 吗啡 芬太尼 

分 类 号：R614[医药卫生—麻醉学]