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1、硬膜外腔注射吗啡联合静脉芬太尼患者门控镇痛临床效果观察【关键词】术后镇痛效果ClinicalobservationofanalgesiaeffectsofsingleepiduralmorphinecombinedwithpatientcontrolledintravenousfentanylCHENShaoYang,ZHUXiaoLing,WEIXiaoLing,HEDaYin,KEYan,HUSheng,XIONGLiZeDepartmentofAnesthesiology,XijingHospital
2、,FourthMilitaryMedicalUniversity,Xi'an710033,China【Abstract]AIM:Toexploretheanalgesiaeffectsofsingleepiduralmorphinecombinedwithpatientcontrolledintravenousfentanyl.METHODS:Inaprospectivestudy,68patientsafteroperationsongallbladderorbileductwererandomlydiv
3、idedinto3groups:singleepiduralmorphinegroup(EM),patientcontrolledintravenousfentanylgroup(PCIFA),andsingleepiduralmorphinecombinedwithpatientcontrolledintravenousfentanyl(MF).2mgmoiphineviatheepiduralroutewasgiveninEMgroup,fentanylwasgivenviatheveininPCIFA
4、group,and1mgmorphineviatheepiduralandfentanylviatheveinweregiveninMFgroup・Theeffectsofanalgesiawereevaluatedbyvisualanaloguescale(VAS),andtheincidenceofcomplicationsincludingnausea,vomiting,itchofskinandretentionofurineandtherecoveryofthedigestivetract'sfu
5、nctionwereobservedfor48hpostoperation.RESULTS:TheVASof24hand48hafteroperationinMFgroupwassignificantlylowerthanthatofthePCIFAgroup(P<0.05),butnosignificantdifferenceswerefoundbetweenthoseofMFandEMgroups6hand24hafteroperation.TheanalgesicsatisfactionrateofM
6、FgroupwassimilartothatofEMgroupbuthigherthanthatofPCIFAgroup(P<0.05).Nosignificantdifferenceswerefoundintheincidenceofnauseaandtherecoveryofdigestivetract'sfunctionamongthethreegroups.TheincidenceofvomitingofMFandPCIFAgroupswashigherthanthatofEMgroup,andth
7、eincidencesoftheitchofskinandtheretentionofurineofEMgroupwerehigherthanthoseofPCIFAgroup(P<0.()5).CONCLUSION:Singleepiduralmorphinecombinedwithpatientcontrolledintravenousfentanyl,canprovidemoreeffectiveanalgesiaeffectswhilenotincreasetheincidencesofcompli
8、cations.【Keywords]postoperativeanalgesiaeffect;patientcontrolledanalgesia,intravenous;epiduralinfusion;morphine;fentanyl【摘要】目的：比较观察三种不同术后镇痛方法，旨在筛选更佳镇痛方案.方法：选择硬膜外麻醉下行胆囊或胆道手术患者68例，按术后不同镇痛方法，随机分为三组，EM组：硬膜外腔单次注射吗
