吗啡与新斯的明注入硬膜外腔术后镇痛的对照研究  

Comparative study of postoperative epidural by neostigmine combined with morphine.

作　　者：郑河荣 骆建宁 

机构地区：[1]珠海市香洲区人民医院麻醉科,广东珠海519070

出　　处：《临床和实验医学杂志》2009年第2期33-34,共2页Journal of Clinical and Experimental Medicine

摘　　要：目的研究吗啡与新斯的明的镇痛作用,同时对其用于硬膜外镇痛的安全性和有效性进行评价。方法采用完全随机设计。随机选择90例拟行腰段硬膜外麻醉的病人随机分为5组,按实验分组予以不同的镇痛配方,用视觉模拟疼痛评分进行疼痛评分,记录相应指标和不良反应。结果镇痛效果从好到差依次为新斯的明1.5 mg加吗啡1.5 mg加氟哌啶2.5 mg组(Ⅰ组)、吗啡2.0 mg加氟哌啶2.5 mg组(对照组)、新斯的明1.0 mg加吗啡1.0 mg加氟哌啶2.5 mg(Ⅱ组)、新斯的明0.7 mg加吗啡0.7 mg加氟哌啶2.5 mg组(Ⅲ组)、新斯的明0.5 mg加吗啡0.5 mg加氟哌啶2.5 mg组(Ⅳ组);Ⅰ组、Ⅱ组、Ⅲ组、Ⅳ组和对照组另加镇痛药使用率分别为0%、2.0%、30.0%、65.0%和6%;不良反应发生率分别为66.7%、20.0%、20.0%、5.0%和73.4%。结论吗啡与新斯的明应用于硬膜外腔有镇痛作用,且新斯的明1.0 mg、吗啡1.0 mg的剂量加氟哌啶能提供相对较好的镇痛作用,不良反应发生率低。Objective To research the effection of Neostigmine combined with Morphine, At the same time, to value the clinical efficacy and safety of epidural analgesia using neostigmine. Methods Ninety patients were randomly and double - blind entered into five groups. Gave each subject the analgesic liquid as required. The pain grading was used for Visual Analogue Scale. Record vital signs, VAS grade, side effections. Results The analgesia effection at post from regards was group Ⅰ,the control group, group Ⅱ, group Ⅲ, group Ⅳ, The using rate of superinduction analgesics from group Ⅰ to the control group was 0% ,2% ,30% ,65% and 6% , the incidence of adverse reaction was 66.7% ,20% ,20%, 5% and 73.4%. Conclusion Epidural neostigmine combined with Morphine can provide analgesia in some degree. Neostigmine 0.5mg and Morphine 0.5 mg produce better analgesia effect than other doses with less side effect.

关 键 词：新斯的明 吗啡 硬膜外腔术 镇痛 对照研究 

分 类 号：R614[医药卫生—麻醉学]