阿扎司琼预防手术后吗啡硬膜外自控镇痛不良反应效果分析  

The effects of azasetron on adverse reaction induced by epidural analgesia with morphine

作　　者：胡宇[1,2] 朱杨子[2] 黄河[2] 刘璐[2] 胡倩[2] 李静[2] 武玉清[2] 

机构地区：[1]徐州医学院附属徐州市妇幼保健院麻醉科,江苏 徐州 221009 [2]徐州医学院江苏省麻醉学重点实验室,江苏 徐州221004

出　　处：《徐州医学院学报》2014年第2期75-77,共3页Acta Academiae Medicinae Xuzhou

基　　金：国家自然科学基金（81070889,81171013）;江苏省高校自然科学基金重大项目（10KJA320052）;江苏高校优势学科建设工程

摘　　要：目的：观察阿扎司琼对妇科手术后吗啡硬膜外自控镇痛（ PCEA ）不良反应的防治效果。方法选取腰硬联合麻醉下行子宫全切除手术患者60例，术后均采用PCEA，镇痛药均为吗啡5 mg＋罗哌卡因200 mg，用生理盐水稀释至100 ml，4 ml/h。随机分成2组，每组30例。 A组不用阿扎司琼，B组手术结束前30 min静脉输注阿扎司琼10 mg。观察各组术后镇痛效果，以及呼吸抑制、皮肤瘙痒、恶心呕吐情况及因为严重的恶心呕吐而要求停止PCEA的例数。结果2组镇痛效果无显著性差别（P＞0．05），B组的恶心呕吐、皮肤瘙痒发生率明显低于A组（P＜0．05）。结论阿扎司琼能有效预防开腹子宫全切术后吗啡硬膜外自控镇痛引起的恶心呕吐及皮肤瘙痒，且对镇痛效果没有明显影响。Objective To observe the preventive effects of azasetron on adverse reaction induced by epidural analge -sia with morphine after gynecological operation .Methods A total of 60 patients underwent hysterectomy with combined spinal anesthesia were randomly divided into two groups .All of them were given patient -controlled epidural analgesia （PCEA） postoperatively.Azasetron was not used in group A （n=30）.Azasetron （10 mg） was injected in group B （n=30 ） 30 min before the end of surgery .The analgesics were 5 mg morphine combined with 200 mg ropivacaine , which was diluted with normal saline to 100 ml.The postoperative analgesic effect , respiratory inhibition , itchy skin , nausea and vomiting were analyzed .The patients who demanded an end of PCEA because of severe nausea and vomiting were al -so observed.Results The analgesic effect was not different obviously between the two groups （P〉0.05）.The inci-dences of nausea, vomiting and itchy skin were markedly lower in group B than in group A （P〈0.05）.Conclusion Azasetron can prevent nausea , vomiting and itchy skin caused by epidural analgesia with morphine after gynecological op -eration, while has no influences on analgesic effect .

关 键 词：阿扎司琼 吗啡 硬膜外镇痛 恶心呕吐 皮肤瘙痒 

分 类 号：R614.42[医药卫生—麻醉学]