吗啡和芬太尼用于术后镇痛效应与不良反应的临床观察  

Observation on effects and side effects of morphine and fentanyl on PCEA

作　　者：刘怀清 刘祥平 冉隆青[2] 

机构地区：[1]重庆市南桐总医院麻醉科,400802 [2]重庆医科大学附属第二医院麻醉科,400010

出　　处：《重庆医学》2006年第8期677-678,共2页Chongqing medicine

摘　　要：目的 观察吗啡、芬太尼用于患者自控硬膜外镇痛（PCEA）的镇痛效应及不良反应。方法 择期手术患者110例，ASAⅠ～Ⅱ级，随机分为两组，Ⅰ组（n=55例）选用吗啡10mg（1ml）加2％利多卡因和0．75％布比卡因各20ml加生理盐水59ml；Ⅱ组（n=55例）选用芬太尼0．5mg（10ml）（代替Ⅰ组配方中的吗啡）加生理盐水50ml。以LCP模式（负荷剂量5ml加持续剂量2ml／h加PCA每次0．5ml）进行镇痛。结果 Ⅰ组与Ⅱ组镇痛效果差异无统计学意义（P〉0．05）；Ⅰ组出现恶心、呕吐、尿潴留、皮肤瘙痒等不良反应发生率较Ⅱ组高（P〈0．01）。结论 吗啡较芬太尼的不良反应更多，应谨慎选用。Objective To observe the effects and adverse effects of morphine and fentanyl on PCEA. Methods One hundred and ten patients with ASA Ⅰ-Ⅱ were randomly divideded into two groups. The drug was blended by 10 mg （1 ml） morphine, 2% lidocaine 20ml,0.75% bupivacine 20ml and NS 59ml in group Ⅰ （55 cases） ; morphine was instead by fentanyl 0.5mg（10ml） in group Ⅱ （55 cases）. Postoperative analgesia was provided with LCP model （ load dosage 5ml＋lasting dosage 2ml/h ＋0. 5ml/per time）. Results The effect of analgesia did not show any significant difference for the two groups （P〉0.05）. The rate of complications just as nausea,vomit,retention of urine and itching was higher in group Ⅰ than that in group Ⅱ （P〈0.01）. Conclusion The side effects of morphine are more than that of fentayl ,morphine should be used more carefully.

关 键 词：吗啡 芬太尼 PCEA 

分 类 号：R614[医药卫生—麻醉学]