吗啡超前镇痛联合低位硬膜外麻醉对老年下肢骨科手术的影响

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Abstract Objective To explore the effect of preemptive analgesia with Morphine combined low epidural anesthesia in lower limb orthopedic surgery for the elderly.Methods A total of 60 elderly patients who underwent lower limb orthopedic surgery in Kangmei Hospital from March to September 2020 were selected as the research objects.According to the random number table method,they were divided into observation group and control group,with 30 cases in each group.Two groups of patients were routinely fasted and watered for 8 hours before operation,and no analgesics were used before operation.All patients were operated by the same anesthesiologist and given epidural anesthesia,and the control group was given 5 mL/(kg·h)saline intravenously 10 min before anesthesia.The observation group was given Morphine 1-1.5 mg(plus normal saline 5 mL)by intravenous injection.The alertness/sedation score(OAA/S),visual analogue scale(VAS),cognitive function(mini-mentalstateexa mination [MMSE]),analgesic duration and adverse reactions were compared between the two groups.Results OAA/S and VAS scores at 12,24 and 48 h after operation were lower than those at the end of operation,and the differences were statistically significant(P＜0.05).There was no significant difference in OAA/S scores between the two groups at each time point(P＞0.05).The VAS scores of the observation group at the end of operation and at 12 and 24 hours after operation were lower than those of the control group,and the differences were statistically significant(P＜0.05).The MMSE scores of the control group at 1 and 3 days after operation were lower than those before operation,and the differences were statistically significant(P＜0.05).There was no significant difference in MMSE scores at each time point in the observation group(P＞0.05).The MMSE scores of the observation group at 1 and 3 days after operation were higher than those of the control group,the differencse were statistically significant(P＜0.05).The analgesic duration of the observation group was longer than that of the control group,the difference was statistically significant(P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P＞0.05).Conclusion Preemptive analgesia with Morphine combined with low epidural anesthesia can achieve good sedative effects on elderly patients undergoing lower limb orthopedic surgery,and the analgesia lasts for a long time.Meanwhile,it can reduce the incidence of postoperative cognitive dysfunction.

Key words： Morphine Preemptive analgesia Low epidural anesthesia Lower limb orthopedic surgery for the elderly

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	ZHOU Jun-qing

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ZHOU Jun-qing. Effect of preemptive analgesia with Morphine combined low epidural anesthesia in lower limb orthopedic surgery for the elderly[J]. 中国当代医药, 2021, 28(13): 141-144.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2021/V28/I13/141

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