吗啡盐酸奈福泮静脉平衡镇痛用于开胸病人的临床研究  

Balance analgesia efficacy of Morphine and Nefopam in thoracic surgical patients

作　　者：宋杰[1] 孙明丽[1] 夏红梅[1] 孙士勇[1] 

机构地区：[1]山东省聊城市第二人民医院麻醉科,山东聊城252601

出　　处：《中国现代医学杂志》2006年第17期2677-2679,共3页China Journal of Modern Medicine

摘　　要：目的探讨开胸手术后吗啡与盐酸奈福泮静脉平衡镇痛与单独应用吗啡效果比较研究。方法ASAⅠ、Ⅱ级60例择期开胸手术病人,随机分为吗啡(A)组(n=30)和吗啡+盐酸奈福泮(B)组(n=30),A组:吗啡60.0mg+恩丹西酮4.0mg,B组:吗啡40.0mg+盐酸奈福泮30.0mg+恩丹西酮4.0mg。均以生理盐水稀释至100mL,给予吗啡2.5mg+恩丹西酮4mg作为负荷量后连接PCIA泵进行自控镇痛。术后第1、2、3天静息及咳嗽时行VAS评分,监测用药量及不良反应发生情况。结果两组VAS评分无明显差异,用药量、不良反应A组明显高于B组。结论吗啡与盐酸奈福泮联合应用于开胸手术后镇痛与吗啡单独应用效果相当,但吗啡用量及不良反应发生率明显降低,是一种更安全、有效的镇痛方法。[Objective] To study the efficacy of patient-controlled analgesia with Morphine and Nefopam versus single Morphine in thoracic surgical patients. [Methods] Sixty ASA Ⅰ -Ⅱ patients were randomly divided into two groups, Morphine group（group A） and Morphine＋ Nefopam group （group B）. Group A（n=30） received Morphine 60.0 mg＋Ondansetron 4.0 mg. Group B （n=30） received Morphine 40.0 mg＋Nefopam 30.0 mg ＋ Ondansetron 4.0 mg. The visual analgesia scale （VAS） was assessed at the first, the second, the third day after operation. Drugs dose and side effects were observed. [Results] VAS was similar in two groups. But drugs dose and side effects were significantly increased in group A compared with those in group B. [Conclusion] The analgesia efficacy of Morphine combined with Nafopam is same as Morphine after thoracic operation, but drugs dose of Morphine and side effects are significantly increased in group A. Group B is more safe and effective.

关 键 词：吗啡 盐酸奈福泮 静脉平衡镇痛 开胸手术 

分 类 号：R614[医药卫生—麻醉学] R655[医药卫生—外科学]