Clinical observation of analgesia effects of single epidural morphine combined with patientª²controlled intravenous fentanyl

    CHEN Shaoª²Yang, ZHU Xiaoª²Ling, WEI Xiaoª²Ling, HE Daª²Yin, KE Yan, HU Sheng, XIONG Liª²Ze

    Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi¡¯an 710033, China

    ¡¾Abstract¡¿ AIM: To explore the analgesia effects of single epidural morphine combined with patientª²controlled intravenous fentanyl. METHODS: In a prospective study, 68 patients after operations on gall bladder or bile duct were randomly divided into 3 groups: single epidural morphine group (EM), patientª²controlled intravenous fentanyl group (PCIFA), and single epidural morphine combined with patientª²controlled intravenous fentanyl (MF). 2 mg morphine via the epidural route was given in EM group, fentanyl was given via the vein in PCIFA group, and 1 mg morphine via the epidural and fentanyl via the vein were given in MF group. The effects of analgesia were evaluated by visual analogue scale (VAS), and the incidence of complications including nausea, vomiting, itch of skin and retention of urine and the recovery of the digestive tract¡¯s function were observed for 48 h postª²operation. RESULTS: The VAS of 24 h and 48 h after operation in MF group was significantly lower than that of the PCIFA group (P<0.05), but no significant differences were found between those of MF and EM groups 6 h and 24 h after operation. The analgesic satisfaction rate of MF group was similar to that of EM group but higher than that of PCIFA group (P<0.05). No significant differences were found in the incidence of nausea and the recovery of digestive tract¡¯s function among the three groups. The incidence of vomiting of MF and PCIFA groups was higher than that of EM group, and the incidences of the itch of skin and the retention of urine of EM group were higher than those of PCIFA group (P<0.05). CONCLUSION: Single epidural morphine combined with patientª²controlled intravenous fentanyl, can provide more effective analgesia effects while not increase the incidences of complications. ......