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目的 :探索小儿硬膜外持续输注吗啡术后镇痛的有效剂量及并发症。方法 :选择ASAI～Ⅱ级择期腹部、尿道及下肢手术行硬膜外复合全麻患儿32例 ,随机分为3组。术毕前60min于硬膜外腔注入30μg/kg吗啡 ,术后镇痛维持量分别为 :组1为1μg·kg-1·h-1 ,组2为1.5μg·kg-1·h-1,组3为2μg·kg-1·h-1。观察镇痛效果及不良反应。结果 :镇痛评分组2、3明显低于组1 ,组3恶心、呕吐、搔痒、呼吸抑制发生率明显高于组1、2。结论 :负荷量30μg/kg,维持量1.5μg·kg-1·h -1为小儿硬膜外持续输注吗啡的安全有效剂量
Objective: To explore the effective dosage and complications of postoperative analgesia after continuous epidural morphine infusion in children. Methods: Thirty-two children undergoing epidural general anesthesia with ASAI ~ Ⅱ elective abdominal, urethral and lower extremity surgery were randomly divided into three groups. 60 minutes before surgery in the epidural space injection of 30μg / kg morphine, postoperative analgesic maintenance were: group 1 1μg · kg-1 · h-1, group 2 1.5μg · kg-1 · h-1 , Group 3 was 2μg · kg-1 · h-1. Analgesic effect and adverse reactions observed. Results: The analgesic scores in groups 2,3 were significantly lower than those in group 1. The incidences of nausea, vomiting, itching and respiratory depression in group 3 were significantly higher than those in groups 1 and 2. CONCLUSION: The safe and effective dose of morphine for continuous epidural infusion in children is 30μg / kg and 1.5μg · kg-1 · h -1