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目的 :观察芬太尼或吗啡配伍布比卡因在术后硬膜外自控镇痛 (PCEA)中的应用 ,并对其临床效应进行比较。方法 :选择心功能 (ASA) ～ 级 ,硬膜外腔麻醉下行中下腹手术患者 40例 ,随机分为两组 ,每组 2 0例 , 组 (芬太尼组 ) :芬太尼 0 .3mg+氟哌利多 2 .5 mg+布比卡因 15 0 mg,用生理盐水稀释至 10 0 ml; 组 (吗啡组 ) :吗啡 2 mg,其它药物同 组。用双盲法观察两组病人术后 2 4h内用药总量、疼痛评分、呼吸循环情况以及有无恶心、呕吐、瘙痒、尿潴留等副反应。结果 :2 4h两组用药总量、疼痛评分无显著性差异 (P >0 .0 5 ) ;两组呼吸循环均稳定 (P >0 .0 5 ) ; 组恶心呕吐、瘙痒、尿潴留发生率均低于 组 ,但无统计学上差异 (P >0 .0 5 )。结论 :两组镇痛效应一致 ,但 组副作用轻。 PCEA时选择芬太尼配伍布比卡因更好。
Objective: To observe the application of fentanyl or morphine in combination with bupivacaine for postoperative epidural analgesia (PCEA) and to compare its clinical effects. Methods: Forty ASA patients undergoing epidural anesthesia were enrolled in this study. Forty patients undergoing epidural anesthesia were randomly divided into two groups (20 cases in each group): fentanyl 0.3 mg + Droperidol 2.5 mg + bupivacaine 15 0 mg, diluted to 10 0 ml with saline; group (morphine): morphine 2 mg, other drugs in the same group. Double-blind observation of two groups of patients within 24 hours after surgery, the total score, pain score, respiratory cycle and whether nausea, vomiting, itching, urinary retention and other side effects. Results: There was no significant difference in pain scores between the two groups at 24 hours (P> 0.05), and the respiratory cycles were stable in both groups (P> 0.05). The incidence of nausea and vomiting, pruritus and urinary retention All were lower than the group, but no statistical difference (P> 0.05). Conclusion: The analgesic effect of the two groups is the same, but the side effects of the group are light. PCEA fentanyl and bupivacaine better choice.