【摘要】 目的比较吗啡、芬太尼用于病人自控硬膜外镇痛(PCEA)的镇痛效果及不良反应。方法60例择期手术患者,ASAⅠ~Ⅱ级,随机分为两组,每组30例。A组选用0.01%吗啡+0.005%氟哌利多+0.01%地塞米松+0.075%丁卡因;B组选用0.004%芬太尼代替A组配方中的0.01%吗啡。均用PCA泵(100m l),以LCP模式(负荷剂量5m l+持续剂量2m l/h+PCA每次0.5m l)进行镇痛。结果①综合镇痛质量,A组与B组无明显差异(P>0.05);②A组恶心、呕吐、尿潴留、嗜睡等发生率较B组高(P<0.01或P<0.05)。结论吗啡、芬太尼PCE用于术后镇痛均可取得满意效果,但芬太尼较吗啡的不良反应少,更适合术后镇痛。更多还原

【Abstract】 Objective To compare the clinical effects and adverse effects of morphine and fentanyl with a patient-controlled epidural analgesia(PCEA) delivery system.Methods ASA Ⅰ～Ⅱ 60 patients undergoing upper abdominal operations were randomly divided into two groups with 30 cases respectively.Group A was given 0.01% morphine+0.005% droperidol+0.01% dexamethasone+(0.075%) tetracaine;In group B 0.0004% fentanyl was given to substitute 0.01% morphine in group A.All patients received PCA(total volume 100ml) and devised in LCP Model(load dose 5ml+continuous infusion 2ml/h+PCA Bolus 0.5ml)after operation.MAP,HR,RR,visual analogue scale(VAS),rmaesay sedation scale(RSS) of 4,8,12,24,36,48h were recorded.Results There were no significantly differences between the two groups in the analgesia(P>0.05);The incidences of nausea,vomiting,uroschesis and somnolence in group A were higher than that in group B(P<0.01 or P<0.05).Conclusion When used in postoperative PCEA,morphine and fentanyl can provide same satisfied effect.However,the adverse effects of fentanyl were lower than those of morphine.Fentanyl is more suitable for postoperative analgesia.更多还原