【摘要】 <正> 解除手术后疼痛,常采用肌肉注射哌替啶,吗啡等镇痛药物。近年来由于体内发现抗痛物质内啡肽(Endonphine)及其特殊的受体以后,临床上将吗啡类镇痛药注入椎管内用于解除晚期恶性肿瘤顽固性疼痛,手术后疼痛等,取得了良好的效果。我科自1981年5月起,应用吗啡、哌替啶等镇痛药以及局麻药马卡因注入硬膜外腔,为手术后的病人,晚期恶性肿瘤和血栓闭塞性脉管病的病人解除疼痛。我们认为此法用药量小,效果确实,对呼吸及循环影响较小。本文总结了硬膜外腔注入吗啡和局麻药马卡因对术后镇痛效果及并发症的观察。更多还原

【Abstract】 Morphine was combined with marcaine and compared to morphine, marcaine and saline in a trial for the relief of postoperative pain among 80 patients who had abdominal operations (20 for each group, randomly divided). Analgesics were given through the epidural catheter just before the conclusion of operation and observations of their analgesic effects and side effects were carried out for 48 hours postoperat-ively. Seven patients in the morphine-marcaine group and 5 patients in the morphine .group had pain relief for 24 to 48 hours.Only one patient in the marcaine group and none in the saline group had pain relief more than 12 hours. Pain was severe in 7 patients of the marcaine group and in all the patients in the saline group. In the morphine and the morphine-marcaine groups there was no respiratory and circulatory depression but 27 patients presented symptoms of retention of urine, while in the other groups, the non morphine groups, only 7 patients had retention of urine. We conclude that the analgesic effect of epidural morphine is dose-related and 2mg has been found to be sufficient and appropriate. And although none of our patients had respiratory depression, analgesics should be administered cautiously, especially in the old, weak or respiratory dysfunction patients.更多还原