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find Keyword "吗啡" 10 results
  • Research on the Sedative Effects of Midazolam Combined with Morphine during Ventilation Treatment for Patients with Acute Severe Left Ventricular Failure

    目的 评价重症急性左心衰竭患者机械通气时采用咪达唑仑与吗啡联合持续镇静的效果。 方法 选择2007年4月-2010年4月在重症医学科(ICU)进行有创机械通气的重症急性左心衰竭患者86例,随机均分为咪达唑仑组(A组)、咪达唑仑联合吗啡组(B组)。采用Ramsay镇静评分,使每例患者镇静水平达RamsayⅢ~Ⅳ级。观察起效时间、镇静时间、停药后苏醒时间和停药后拔管时间;监测镇静12 h后的血气分析及血流动力学参数的变化。 结果 B组起效时间、镇静时间、停药后苏醒时间和停药后拔管时间明显短于A组(P<0.05)。且镇静12 h后B组血气分析及血流动力学较A组明显改善(P<0.05)。 结论 重症急性左心衰竭患者机械通气时使用咪达唑仑联合吗啡镇静能达到满意镇静效果,同时改善重症急性左心衰竭患者的低氧血症和高碳酸血症。

    Release date:2016-09-08 09:16 Export PDF Favorites Scan
  • 吗啡缓释片直肠给药致蓄积中毒一例

    【摘要】 目的 报道并分析1例疼痛患者使用吗啡缓释片直肠给药镇痛过程中出现蓄积中毒的不良反应。 方法 采用病例报告的形式并结合药品使用说明书进行分析。 结果 吗啡缓释片说明书上并未有直肠给药途径,该患者使用吗啡缓释片塞肛属于超说明书用药。 结论 在临床中不推荐吗啡缓控释制剂作为直肠给药,如果无法避免需要使用该途径时,也应从小剂量开始逐渐增加剂量,尤其老年患者,应更加谨慎使用。

    Release date:2016-09-08 09:27 Export PDF Favorites Scan
  • 下肢手术后吗啡、罗哌卡因和地塞米松配伍镇痛效果比较

    【摘要】 目的 总结吗啡、罗哌卡因和地塞米松三种药物复合在下肢手术后硬膜外单次给药维持镇痛的时间及并发症。方法 2006年3月—2009年8月收治ASAⅠ~Ⅱ级骨科下肢手术患者120例,随机分为两组,每组60例。A组吗啡2.5 mg加罗哌卡因20 mg,B组吗啡2.5 mg加罗哌卡因20 mg加地塞米松5 mg,均用生理盐水稀释至10 mL,于手术后分两次注入硬膜外腔。观察两组患者术后6、12、24 h VAS评分情况;术后镇痛(VAS≤3分)维持时间及另一侧下肢运动功能恢复时间;术后呼吸抑制、恶心呕吐和皮肤瘙痒的副作用发生情况。结果 两组患者术后6、12 h VAS评分均<3分,但24 h A组VAS评分(>4分)明显高于B组;B组患者术后无痛时间明显长于A组,术后另一侧下肢运动功能恢复时间两组基本相同;两组患者均未发生呼吸抑制,恶心呕吐发生率相似,但A组皮肤瘙痒发生率高于B组(Plt;0.05)。结论 吗啡加罗哌卡因加地塞米松硬膜外给药可维持下肢手术患者术后镇痛24 h以上,且并发症少。

    Release date:2016-09-08 09:37 Export PDF Favorites Scan
  • 硫酸吗啡栓用于肛周脓肿术后镇痛的临床观察

    目的探讨硫酸吗啡栓对肛周脓肿术后患者的镇痛作用。 方法选择2013年1月-2014年5月住院行肛周脓肿手术患者66例,按随机数字表法分为治疗组与对照组,每组33例。两组患者均于术后6 h开始用药。治疗组给予硫酸吗啡栓 20 mg,纳肛,1次/d;对照组给予氨酚双氢可待因片40 mg口服,2次/d。3 d后,比较两组的镇痛效果。 结果治疗组术后3 d内用药后疼痛评分分值较对照组低,差异有统计学意义(P<0.05)。治疗组2例切口轻度水肿,1例切口中度水肿,2例出现恶心、呕吐症状;对照组4例切口轻度水肿,3例切口中度水肿,3例出现胃痛反应;两组患者不良反应发生率差异无统计学意义(χ2=2.157,P=0.142)。 结论硫酸吗啡栓应用于肛周脓肿患者术后镇痛简单方便,安全有效,副作用小。

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  • Transdermal Fentanyl versus Morphine for Moderate/Severe Cancer Pain: A Systematic Review

    ObjectiveTo systematically review the efficacy of transdermal fentanyl versus oral morphine for moderate/severe cancer pain. MethodsDatabases such as The Cochrane Library (Issue 1, 2014), PubMed, Web of Science, CNKI, VIP, CBM and WanFang Data were searched for randomized controlled trials (RCTs) on the efficacy of transdermal fentanyl versus oral morphine for moderate/severe cancer pain up to January 2014. According to inclusion and exclusion criteria, two reviewers independently screened literature, extracted data, and assessed methodological quality of included studies. Then meta-analysis was performed using RevMan 5.1.0 software. ResultsA total of 35 RCTs involved 3 406 patients were included. The results of meta-analysis showed that, there was no significant difference in effectiveness between transdermal fentanyl and oral morphine for moderate/severe cancer pain (OR=1.00, 95%CI 0.80 to 1.27, P=0.99). Compared with oral morphine, transdermal fentanyl was better in lowering the incidences of constipation, nausea and vomiting, lethargy and urinary retention; but transdermal fentanyl increased the incidences of skin rashes and itch (P < 0.05). ConclusionTransdermal fentanyl is as effective as oral morphine in the treatment of moderate/severe cancer pain, and transdermal fentanyl causes less side effects. Due to poor quality of the included studies, the above conclusion should be verified by further conducting more high quality RCTs.

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  • 硫酸吗啡口服液在腹腔镜胆囊手术患者术后镇痛中的效果观察

    目的 观察术前单次服用硫酸吗啡口服液联合术后曲马多自控镇痛在腹腔镜胆囊切除术后的镇痛效果。 方法 2013 年 11 月—2014 年 3 月选择美国麻醉医师协会分级为Ⅰ~Ⅲ级,年龄 18~67 岁,择期行腹腔镜胆囊切除术患者 54 例,随机分为试验组(硫酸吗啡口服液组)和对照组(安慰剂组),各27例。采用疼痛视觉模拟(Visual Analogue Scale,VAS)评分评价两组患者术后清醒(T1)及术后 4 h(T2)、8 h(T3)、12 h(T4)与 24 h(T5)疼痛程度(分别评估静息痛与运动痛),并对各时间点自控镇痛按压次数、曲马多总给药量及不良反应发生率进行对比。 结果 两组患者术后各时间点 VAS 评分均< 4 分,试验组术后 T1、T2 运动痛 VAS 评分显著小于对照组(P<0.05),但静息痛及其余时间点运动痛 VAS 评分组间比较均无统计学意义(P>0.05);试验组的自控镇痛按压次数和曲马多给药总量均少于对照组(P<0.05);两组患者出现恶心、呕吐、呼吸抑制、尿潴留不良反应的发生率比较均无统计学意义(P>0.05)。 结论 术前单次给予 30 mg 硫酸吗啡口服液联合术后给予曲马多自控镇痛可以减轻腹腔镜胆囊切除术患者术后短期内的运动痛,同时可减少曲马多的使用量,但并不会降低其不良反应的发生率。

    Release date:2017-06-22 02:01 Export PDF Favorites Scan
  • Efficacy and safety of oxycodone versus morphine for postoperative intravenous self-control analgesia: a systematic review

    ObjectiveTo systematically review the efficacy and safety of oxycodone versus morphine for postoperative intravenous self-control analgesia (PCIA). MethodsWe searched databases including PubMed, EMbase, The Cochrane Library (Issue 8, 2015), CBM, CNKI, VIP, WanFang Data from inception to August 2015, to collect randomized controlled trials (RCTs) about oxycodone versus morphine for postoperative PCIA. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software.ResultsSeven RCTs involving 826 patients were included. The results of meta-analysis showed that: there were no significant differences in postoperative analgesia at the points of 2 h, 3 h, 4 h, 8 h, 12 h, 24 h, 36 h and 48 h after surgery (2 h: MD=0.20, 95%CI –0.18 to 0.58, P=0.30; 3 hresting state: MD=–0.51, 95%CI –2.27 to 1.26, P=0.57; 3 hdynamic state: MD=–0.46, 95%CI –2.23 to 1.40, P=0.63; 4 h: MD=0.00, 95%CI –0.25 to 0.25, P=0.99; 8 h: MD=0.10, 95%CI –0.16 to 0.36, P=0.46; 12 h: MD=–0.34, 95%CI –0.85 to 0.17, P=0.19; 24 h: MD=–0.13, 95%CI –0.43 to 0.17, P=0.41; 36 h: MD=0.10, 95%CI –0.28 to 0.48, P=0.60; 48 h: MD=–0.13, 95%CI –0.36 to 0.09, P=0.25). The incidences of postoperative vomiting (OR=0.23, 95%CI 0.08 to 0.63, P=0.005), nausea (OR=0.27, 95%CI 0.08 to 0.86, P=0.03), respiratory depression (OR=0.15, 95%CI 0.04 to 0.53, P=0.003) and skin pruritus (OR=0.19, 95%CI 0.05 to 0.66, P=0.009) in the oxycodone group were lower than those in the morphine group. In addition, there were no significant differences of the incidences of headache, dizzy and shiver between two groups.ConclusionCompared with morphine, oxycodone has the same analgesia effect for PCIA, however, the incidences of adverse reactions are lower. Due to the limited quality and quantity of included studies, the above results are needed to be validated by more high quality studies.

    Release date:2017-06-16 02:25 Export PDF Favorites Scan
  • Hydromorphone versus morphine in the treatment of postoperative analgesia after cesarean section: a systematic review

    ObjectivesTo systematically review the efficacy and safety of hydromorphone and morphine in post-cesarean section analgesia.MethodsThe Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMbase, CNKI, WanFang Data, VIP and SinoMed databases were electronically searched to identify randomized controlled trials (RCTs) of hydromorphone vs. morphine in the treatment of postoperative analgesia after cesarean section from the inception of the database to December 2017. Two reviewers independently screened literatures, extracted data and assessed risk of bias of the included trials. The meta-analysis was conducted with RevMan 5.3 software.ResultsSeven trials with 586 post-cesarean section patients were included. The results of the meta-analysis showed that, compared with the morphine group, the hydromorphone group had lower 6 h (MD=–0.23, 95%CI –0.38 to –0.08, P=0.003), 12 h (MD=–0.56, 95%CI –1.10 to –0.02, P=0.04), 24 h (MD=–0.37, 95%CI –0.65 to –0.09, P=0.01) and 48 h (MD=–0.41, 95%CI –0.74 to –0.08, P=0.01) postoperative VAS scores the with epidural anesthesia pump (PECA). There was no statistically significant difference of the postoperative Ramsay scores between the two groups. In terms of side effects, the incidence of skin pruritus (RR=0.27, 95%CI 0.09 to 0.81. P=0.02) and vomit (RR=0.15, 95%CI 0.03 to 0.65, P=0.01) of the hydromorphone group were lower than those of the morphine group.ConclusionsThe current evidence demonstrate that, compared with morphine, hydromorphone has better postoperative analgesia performance and less risk of exhibiting skin pruritus and vomit after cesarean section. Considering of the overall quality of evidence and the relatively small pooled sample size, more well-conducted randomized controlled trials are required to verify the above conclusion.

    Release date:2019-02-19 03:57 Export PDF Favorites Scan
  • The study of morphine mitochondrial toxicity impact on cat electroencephalogram

    ObjectiveTo analyze the effect of mitochondrial ultrastructural changes caused by morphine toxicity on abnormal discharge of cat cerebral cortex, and to explore the possible mechanism of brain function damage caused by morphine dependence.MethodsTwelve domestic cats were divided into control group (3 cats) and morphine exposed group (9 cats) according to the method of random number table. After the model was successfully established by the method of dose increasing, the changes of mitochondrial ultrastructure of cortical neurons were observed under the electron microscope.ResultsElectroencephalogram (EEG) monitoring in morphine exposed group showed that the cortical EEG was widely abnormal, physiological waves were reduced, and abnormal discharges were frequent. And the electron microscopy showed that the number, morphology, internal membrane structure and the inclusion body in the matrix of neurons changed in various aspects. The EEG and electron microscopy of the control group were normal.ConclusionMorphine can damage neurons in the cerebral cortex and lead to abnormal discharge, which is closely related to the ultrastructural changes of neuron mitochondria. The toxicity of morphine mitochondria can be the initial mechanism of energy metabolism dysfunction of brain cells and eventually lead to the disorder of brain electrophysiological function.

    Release date:2020-03-20 08:06 Export PDF Favorites Scan
  • Analysis of constipation status and influencing factors in patients with lung cancer during postoperative hospitalization

    Objective To investigate the current status of constipation during postoperative hospitalization and the factors associated with moderate to severe constipation at discharge in lung cancer patients. Methods Lung cancer patients who underwent surgery in 6 tertiary hospitals in Sichuan Province from November 2017 to January 2020 were enrolled. The MD Anderson Symptom Scale-Lung Cancer Module was used to collect postoperative constipation scores. Unconditional logistic stepwise regression was used to analyze the related influencing factors for moderate to severe constipation on the day of discharge. Results Finally 337 patients were collected. There were 171 males and 166 females, with an average age of 55.0±10.3 years. Constipation scores of lung cancer patients increased from postoperative day 1 to day 3, and showed a decreasing trend from day 3 to day 7. Moderate to severe constipation was present in 68 (20.2%) patients at discharge. The postoperative hospital stay (OR=0.743, P<0.001) and the dose of morphine used during postoperative hospitalization (OR=1.002, P=0.015) were influencing factors for moderate to severe constipation at discharge in lung cancer patients. ConclusionLung cancer patients have the most severe constipation on postoperative day 3. Moderate to severe constipation at discharge is associated with the postoperative hospital stay and the dose of morphine used during postoperative hospitalization.

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