蛛网膜下腔吗啡用于剖宫产术后镇痛效果及对血泌乳素的影响

Postoperative analgesic effect of intrathecal morphine on cesarean section and its influence on PRL

目的观察蛛网膜下腔吗啡用于剖宫产术后镇痛效果及对血泌乳素的影响。方法 40例剖宫产产妇随机分为蛛网膜下腔吗啡镇痛组(Ⅰ组)及术后疼痛时用哌替啶肌注对照组(Ⅱ组),每组20例。观察术后6、12、24、48hVAS评分以及术后24、48h血浆泌乳素(PRL)水平,另外观察新生儿的Apgar评分及术后恶心呕吐和皮肤瘙痒发生率。结果Ⅰ组的术后镇痛效果明显优于Ⅱ组(P<0.01),术后24、48h的PRL水平亦高于Ⅱ组(P<0.05)。结论蛛网膜下腔吗啡用于剖宫产术后镇痛可取得非常满意的效果,并可促进术后泌乳素的分泌水平。

Aim To observe the postoperative analgesic effect of intrathecal morphine on cesarean section and ito influence on the level of PRL.Methods Forty term parturients undergoing cesarean section with spinal anesthesia were randomly divided into two groups（Group Ⅰ and Group Ⅱ）,with 20 cases in each group.Group Ⅰ received intrathecal morphine before operation and group Ⅱ received pethidine with intramuscular injection after operation as control group.Visual analogue scale（VAS）at 6,12,24,48 hours after operation,and the level of PRL at 24,48 hours were measured.Additionally,Apgar of newborn and the incidence of disgust,vomiting and pruritus were observed.Results Analgesic effect of group Ⅰ is obvisiously superior to that of group Ⅱ（P〈0.01）.Also the level of PRL at 24,48 hours of group Ⅰ is higher than group Ⅱ（P〈0.05）.Conclusion Intrathecal morphine used for postoperative analgesia of cesarean section can obtain satisfactory effect.It could also increase the level of PRL and promote the success rate of breast feeding.