剖宫产术后硬膜外镇痛药布托啡诺与吗啡的临床应用

Splits the palace to produce the technique outside the hard membrane the analgesic Bhutto fei promise and morphine dinical practice

目的：探讨布托啡诺与吗啡在割宫产术后硬膜外镇痛中的临床应用。方法：将100例孕妇随机分为两组，布托啡诺组50例（A组），镇痛液为0．15％罗哌卡因加0．004％布托啡诺；吗啡组50例（B组），镇痛液为0．15％罗哌卡因加0．004％吗啡。采用视觉模拟镇痛评分法（VAS）：0分为无痛，10分为剧痛。VAS〈3分为镇痛良好，3～4分为基本满意，≥5分为镇痛差。观察48h内瘙痒发生率并记录恶心、呕吐发生情况予以评分：0分为无恶心、呕吐；1分为有恶心、无呕吐；2～3分为恶心、呕吐。结果：两组年龄、体重、麻醉平面、局麻药用量、手术时间差异均无显著性。A组发生恶心、呕吐3例（6％），无皮肤瘙痒患者。B组发生恶心、呕吐16例（32％），皮肤瘙痒12例（24％）。两组差异有显著性，P〈0．01。结论：布托啡诺硬膜外注射用于剖宫产术后镇痛，镇痛效果确切，与吗啡相当，但恶心、呕吐、瘙痒的发生率明显低于吗啡，是剖宫产术后镇痛治疗的理想药物。

Objective：To discuss butorphanol and morphine in the epidural analgesia after cesarean section. Methods 100 cases of pregnant women were randomly divided into two groups,butorphanol group of 50 patients（A group）, with analgesic liquid of 0. 15 ropivacaine plus 0. 004%butorphanol;morphine group of 50 patients（B group）, with analgesic solution of 0.15 %ropivacaine plus 0. 004% morphine. The use of visual analogue pain score（VAS） ：0 was painless, 10 was pain. VAS〈3 was good analgesic, 3 - 4 was basic satisfaction,≥ 5 was poor analgesia. Observed within 48 h itching and recorded the incidence of nausea,vomiting were scored： 0 （no nausea, vomiting） ; 1 （there are nausea, no vomiting） ; 2- 3 （nausea, vomiting）. Results Two groups of age, weight, anesthesia plane, the amount of local anesthetics, surgical time had no significant difference. A group in nausea, vomiting were 3 cases（6 % ）, no pruritus patients. B group in nausea, vomiting were 16 cases（32%）, 12 cases were skin itching（24 % ）. The two groups had a significant difference,P〈0.01. Conclusion Butorphanol epidural analgesia for cesarean section had exact analgesic effect with morphine, but nausea, vomiting, the incidence of pruritus was significantly lower than morphine,is an ideal drug for pain after cesarean section.