关键词: 静脉, 硬膜外, 吗啡, 布比卡因, 镇痛

Abstract: AIM: To compare the analgesic efficacy and safety of intravenous morphine or epidural morphine combined with bupivacaine in postoperative children. METHODS: 48 children scheduled for selective inferior belly or lower limb surgery under general anaesthesia or epidural anesthesia for ASA I or II, age from 3 to 10 years old, were randomly divided into 3 groups(n=16 each).Group A was given intravenous morphine for postoperative analgesia, group B was given epidural morphine in combination with bupivacaine, group C was given nonsteroidal anti-inflammatory drugs orally or pethidine intramuscularly in need as the control group.When the patients were fully awake in the recovery area, heart rate (HR), blood pressure, peripheral oxygen saturation (SpO₂), respiratory rate and pain were recorded at 2, 4, 8, 12, 24 and 48 h postoperatively, side-effects were also noted.Pain was assessed using an objective pain score (OPS). RESULTS: There was no significant difference of OPS between group A and B, and the efficacy and duration of analgesia in group A and B were significantly better than those in group C (P<0.05).The incidence of drowsiness, nausea and vomiting was higher in group A than that in the other 2 groups. CONCLUSION: Intravenous morphine or epidural morphine in combination with bupivacaine are both effective for postoperative analgesia in children.Epidural group outweigh intravenous group in terms of its lower incidence of side-effects.

Key words: intravenous, epidural, morphine, bupivacaine, analgesia