CAJ | 학술논문

目的：观察阿扎司琼对妇科手术后吗啡硬膜外自控镇痛（ PCEA ）不良反应的防治效果。方法选取腰硬联合麻醉下行子宫全切除手术患者60例，术后均采用PCEA，镇痛药均为吗啡5 mg＋罗哌卡因200 mg，用生理盐水稀释至100 ml，4 ml/h。随机分成2组，每组30例。 A组不用阿扎司琼，B组手术结束前30 min静脉输注阿扎司琼10 mg。观察各组术后镇痛效果，以及呼吸抑制、皮肤瘙痒、恶心呕吐情况及因为严重的恶心呕吐而要求停止PCEA的例数。结果2组镇痛效果无显著性差别（P＞0．05），B组的恶心呕吐、皮肤瘙痒发生率明显低于A组（P＜0．05）。结论阿扎司琼能有效预防开腹子宫全切术后吗啡硬膜外自控镇痛引起的恶心呕吐及皮肤瘙痒，且对镇痛效果没有明显影响。
목적：관찰아찰사경대부과수술후마배경막외자공진통（ PCEA ）불량반응적방치효과。방법선취요경연합마취하행자궁전절제수술환자60례，술후균채용PCEA，진통약균위마배5 mg＋라고잡인200 mg，용생리염수희석지100 ml，4 ml/h。수궤분성2조，매조30례。 A조불용아찰사경，B조수술결속전30 min정맥수주아찰사경10 mg。관찰각조술후진통효과，이급호흡억제、피부소양、악심구토정황급인위엄중적악심구토이요구정지PCEA적례수。결과2조진통효과무현저성차별（P＞0．05），B조적악심구토、피부소양발생솔명현저우A조（P＜0．05）。결론아찰사경능유효예방개복자궁전절술후마배경막외자공진통인기적악심구토급피부소양，차대진통효과몰유명현영향。
Objective To observe the preventive effects of azasetron on adverse reaction induced by epidural analge -sia with morphine after gynecological operation .Methods A total of 60 patients underwent hysterectomy with combined spinal anesthesia were randomly divided into two groups .All of them were given patient -controlled epidural analgesia (PCEA) postoperatively.Azasetron was not used in group A (n=30).Azasetron (10 mg) was injected in group B (n=30 ) 30 min before the end of surgery .The analgesics were 5 mg morphine combined with 200 mg ropivacaine , which was diluted with normal saline to 100 ml.The postoperative analgesic effect , respiratory inhibition , itchy skin , nausea and vomiting were analyzed .The patients who demanded an end of PCEA because of severe nausea and vomiting were al -so observed.Results The analgesic effect was not different obviously between the two groups (P>0.05).The inci-dences of nausea, vomiting and itchy skin were markedly lower in group B than in group A (P<0.05).Conclusion Azasetron can prevent nausea , vomiting and itchy skin caused by epidural analgesia with morphine after gynecological op -eration, while has no influences on analgesic effect .