纳美芬对硬膜外吗啡镇痛的影响
投稿时间:2014-10-22  修订日期:2014-12-22  点此下载全文
引用本文:许波,汪小海,王志萍,高宏.纳美芬对硬膜外吗啡镇痛的影响[J].医学研究杂志,2015,44(7):139-141
DOI: 10.11969/j.issn.1673-548X.2015.07.039
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作者单位E-mail
许波 214023 南京医科大学附属无锡市人民医院麻醉科 xubo1028@sina.com 
汪小海 南京市鼓楼医院麻醉科  
王志萍 214023 南京医科大学附属无锡市人民医院麻醉科  
高宏 214023 南京医科大学附属无锡市人民医院麻醉科  
中文摘要:目的 纳美芬静脉给药对术后硬膜外单次吗啡镇痛的效果和不良反应的临床观察。方法 剖宫产患者90例,ASAⅠ~Ⅱ级 ,经L2~L3硬膜外腔穿刺置管麻醉,术毕硬膜外导管单次推注吗啡2mg(5ml)后随机分为3组,Ⅰ组静脉注射0.25μg/kg纳洛酮(5ml);Ⅱ组静脉注射0.1μg/kg纳美芬(5ml);Ⅲ组静脉注射0.2μg/kg纳美芬(5ml)。观察3组患者术后24h疼痛评分,下肢麻木、恶心、呕吐发生率及皮肤瘙痒的发生情况。结果 与Ⅰ组相比,Ⅱ、Ⅲ组的疼痛评分、下肢麻木发生率差异无统计学意义(P>0.05);Ⅱ、Ⅲ组在6、12、24h恶心、呕吐发生率及皮肤瘙痒发生率低于Ⅰ组,在3h与Ⅰ组比较,差异无统计学意义(P>0.05),Ⅱ、Ⅲ组之间在任何时刻不良反应发生率比较,差异无统计学意义(P>0.05)。结论 对比小剂量纳洛酮,纳美芬静脉给药可更长时间降低硬膜外吗啡单次镇痛引起的不良反应,镇痛方法可靠而有效。
中文关键词:阿片受体拮抗药  吗啡镇痛  硬膜外麻醉
 
Effect of Nalmefene on Morphine Epidural Analgesia
Abstract:Objective To evaluate the effect of nalmefene in the postoperative treatment of patients with epidural single morphine analgesia on analgesia and adverse reactions. Methods Ninety elective cesarean section of patients,ASA gradeⅠ-Ⅱ,who received postoperative epidural infusion of 2 mg morphine (5 ml), were randomly divided into three groups(group Ⅰ:iv 0.25μg/kg naloxone (5ml); groupⅡ:iv 0.1μg/kg nalmefene (5ml); group Ⅲ:iv 0.2μg/kg nalmefene (5ml)).The analgesia effect was evaluated by pain score and the incidence of nausea, vomiting, itching and numbness of lower limb were recorded after injection of 3,6,12 and 24h. Results Compared with groupⅠ, group Ⅱand Ⅲ had no obvious difference with pain score and the incidence of numbness of lower limb. The incidence of nausea, vomiting and itching in groupⅡ and Ⅲ were decreased after 6,12 and 24h and had no difference after 3h compared with those in groupⅠ. Moreover,they had no difference between group Ⅱ and Ⅲ at any time. Conclusion Compared with small doses of naloxone, nalmefene can effectively reduce adverse reactions after postoperative epidural infusion of morphine, which were reliable and effective analgesia method.
keywords:Opioid receptor antagonist  Morphine analgesia  Epidural anesthesia
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