ĐÁNH GIÁ TÁC DỤNG VÔ CẢM VÀ GIẢM ĐAU SAU MỔ CỦA GÂY TÊ TỦY SỐNG BẰNG BUPIVACAIN KẾT HỢP VỚI CÁC LIỀU MORPHIN KHÁC NHAU TRONG PHẪU THUẬT CHẤN THƯƠNG CHI DƯỚI

Abstract

Objective: To compare the nerve block effects and postoperative pain management of spinal anesthesia by 8mg bupivacaine 0.5% combined with 100mcg, 200mcg, 300mcg morphine in lower extremity surgery at 105 Military Hospital from November 2018 to April 2019. Method: prospective randomized controlled trial interventional study. The patients were divided into three random groups: Group I included 40 patients who received 8 mg bupivacaine combined with 0,1 mg morphine. Group II consisted of 40 patients who received 8 mg bupivacaine combined with 0,2 mg morphine. Group III consisted of 40 patients who received 8 mg bupivacaine combined with 0,3 mg morphine. Results: The nerve block time of 3 groups lasted nearly the same, with group I, II and III were: at T12 level was 140 ¸ 235 minutes; at T10 was 90 ¸ 190 minutes; at T6 level was 65 ¸ 135 minutes, there was no statistically significant with p> 0.05. Group III with 0.3mg morphine had the longest postoperative analgesia time: 29.87 ± 7.00 hours, followed by group II with 0.2mg morphine of 22.33 ± 4.44 hours and the lowest was group I with 0.1mg morphine of 18.28 ± 3.86 hours, the difference had statistically meaning with p <0.05. Conclusions: Analgesia morphine dose: should apply dose of 0,3mg due to the longer lasting than dose of 0,2mg or 0,1mg.