布比卡因复合吗啡用于横切口剖宫产术后腹直肌鞘内镇痛观察

Analgesic Effects of Bupivacaine and Morphine Injected Intrathecally of Rectus Abdominis Muscle after Cesarean Section of Transverse Incision

目的:探讨腹直肌鞘内注入0.5%布比卡因+吗啡混合液横切口剖宫产术后镇痛效果。方法:46例拟行横切口剖宫产术患者被随机分为观察组与对照组两组,每组23例。观察组使用腹直肌鞘内给药,即在关闭腹直肌前鞘时,向腹直肌鞘内注入0.5%布比卡因5 mL+吗啡3 mg混合液。对照组使用硬膜外腔内给药,既在手术关腹时向硬膜外腔内注入0.5%布比卡因5 mL+吗啡2 mg混合液。两组均观察24 h,并记录患者的Prince-Henry评分。结果:对照组由于手术后早期出现恶心、呕吐,导致4 h评分高于观察组,经统计学处理,两组有显著差异(P<0.05);8、12、162、4 h评分观察组与对照组之间无显著差异(P>0.05)。结论:腹直肌鞘内注入0.5%布比卡因+吗啡混合液横切口剖宫产术后镇痛效果好,无明显副作用,简便易行,值得推广应用。

Objective. To explore the analgesic effects of 0.5% bupivacaine and morphine injected intrathecally of rectus abdominis muscle after cesarean section of transverse incision. Methods： Cesarean section of transverse incision in 46 cases were randomly divided into observe group and control group with 23 in each group. In observe group 0. 5% bupivacaine 5 mL and morphine 3 nag were injected intrathecally during close the anterior theca of rectus abdominis muscle, control grout） with 0.5% bupivacaine 5 mL and morphine 2 mg were injected epidurally during close tile abdominal cavity,and observed for 24 h in both groups to record prince-henry score at same time. Results ：Because of the com rol group which appeared naused and vomiting during the early stage after operation,the score of 4 h was higher than that in observation group, h showed that there existed significam difference（P〈0. 05）between the indices of the observation group and the control group,the results of the score of 8 h, 12 h, 16 h,24 h, the observation group and the centrol group were no significam difference（P〉0. 05）between them. Conclusion： The analgesia with 0. 5 % bupivacaine and morphine injected intratheeally of rectus abdominis muscle of cesarean section of transverse incision may be a effective analgesic method. The way is safe, simple and no side effects,which may be used widely.