关键词: 吗啡, 全子宫切除术, 腹横肌平面阻滞, 布比卡因

Abstract: Objective To investigate the analgesic effect of morphine added to bupivacaine in transversus abdominis plane block（TAPB）for total abdominal hysterectomy. Methods This is a prospective study where 94 patients prepared to received total abdominal hysterectomy were assigned to the control group and the observation group（n=47）. After general anesthesia patients received TAPB about 15 min before surgery. TAPB anaesthetics in the control group were 0.5% bupivacaine hydrochloride 20 ml plus normal saline 20 ml，and those in the observation group were 0.5% bupivacaine hydrochloride 20 ml plus morphine 10 mg and normal saline 20 mL. TAPB anaesthetics 20 ml were respectively injected in bilateral sides. Results Visual analog pain scale at rest and during movement at 2，4，8，12，18 and 24 h postoperatively was significantly lower in the observation group than that in the control group （P< 0.05）. Moreover，ratio of using morphine intravenous patientcontrolled analgesia（IV PCA）and morphine IV?PCA consumption at 24 h were significantly less in the observation group than that in the control group（P<0.05）. Time for first request of analgesia was significantly longer in the observation group than that in the control group（P<0.05）. Ratio of postoperative nausea and vomiting was significantly lower in the observation group than that in the control group（P<0.05）. Conclusion Morphine added to bupivacaine TAPB could significantly decrease visual analog pain scale，morphine consumption and ratio of adverse effect and prolong the time for first request of analgesia at 24 h postoperatively for total abdominal hysterectomy patients，which is worth popularizing clinically.

Key words: morphine, total abdominal hysterectomy, bupivacaine, transversusabdominis plane block