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硬膜外持续注入吗啡用于开胸手术后镇痛的研究
Effects of continuous constant epidural infusion of morphine for postoperative analgesia after thoracic surgery
<<癌症 >>2000年06期
曾灿光 , 陆霄云 , 许梅曦 , 李伟 , 林文前

目的:探讨硬膜外持续恒速注入吗啡镇痛技术（continuousconstantepiduralanalgesiaCCEA）用于开胸手术后镇痛的效果及安全性。方法:100例ASA1～3级开胸肿瘤手术病人随机分为CCEA组和肌注吗啡镇痛组(IM组)。记录术后4、12、24、36、48小时两组病人镇痛、镇静评分及副作用发生情况，持续监测血压、心率、呼吸频率、脉搏氧饱和度、血气等体征，并于术后72小时对两组病人进行镇痛满意度调查。结果:CCEA组病人镇静评分、病人满意度评分显著高于IM组，镇痛评分显著低于IM组(P<0.01)。IM组病人HR、RR显著增高 ，SpO2降低(P<0.05)。结论:开胸手术后应用CCEA技术，镇痛完全，安全，并能改善呼吸功能。
Objective: To evaluate the efficacy and safety of continuous constant epidural infusion morphine combined with 0.125％ Bupivcaine for postoperative analgesia after thoracic surgery. Method:One hundred patients scheduled for thoracic surgery under general anesthesia were randomly allocated to one of both groups respectively:CCEA group (n=50)and intramuscular analgesia group ( IM group n=50). Pain scores、 sedation scores and patients satisfaction scores toward analgesia were recorded, and HR, MAP, RR, SpO2, Blood gas analysis were monitored in two groups after 4, 12, 24, 36, 48 hour of operation. Results: In CCEA group the sedation scores, patients satisfaction scores were significantly higher but pain scores were markedly lower than those in group IM( P< 0.01). HR, RR in group IM increased significantly, SpO2 was markedly decreased (P< 0.05). Conclusion: After thoracic surgery CCEA is a safe and effective analgesia method,also can improve respirative function.