蛛网膜下腔注射吗啡对剖宫产产妇寒战的影响

Effects of Intrathecal Morphine on Shivering in Parturients During Cesarean Section

目的：研究蛛网膜下腔注射吗啡对剖宫产产妇寒战的影响。方法：剖宫产产妇１００ 例，随机等分为两组，Ⅰ组实验组和Ⅱ组对照组。选用联合腰麻硬膜外麻醉，于Ｌ３～４ 间隙蛛网膜下腔注入腰麻液３ｍｌ（含布比卡因７－５ｍｇ），Ⅰ组腰麻液含盐酸吗啡０－５ｍｇ。记录阻滞平面、ＢＰ和ＨＲ，观察病人寒战发生情况。结果：寒战发生例数Ⅰ组２６ 例，明显低于Ⅱ组３７ 例（ Ｐ＜ ０－０５） ；重度寒战Ⅰ组１１ 例，Ⅱ组２４ 例，Ⅰ组明显低于Ⅱ组（Ｐ＜ ０－０１）；胎儿娩出前出现寒战者Ⅰ组４ 例，明显少于Ⅱ组１５ 例（Ｐ＜ ０－０１） 。结论：蛛网膜下腔注射吗啡可降低剖宫产产妇胎儿娩出前寒战发生率及总发生率。

Objective:To determine the effects of intrathecal morphine on shivering during cesarean section following spinal anesthesia.Methods:Parturients undergoing cesarean section were randomly allocated in to group Ⅰ( n= 50) and group Ⅱ( n= 50).Intrathecal injection of 3ml solution consisting of bupivacaine 7 5mg with morphine 0 5mg in group Ⅰ or without morphine in group Ⅱ was performed at the L 3～4 interspace.Analgisic level at 10min after intrathecal injection, and BP,RR and sedatioin score were recorded.Shivering was evaluated for a period of one hour.Results:There was no significant difference between the two groups in blocked level,BP,RR and sedatioin score.Twenty six parturients in group Ⅰ shivered compared with 37 in group Ⅱ( P< 0 05).Eleven cases with severe shivering were seen in group Ⅰ and 24 in group Ⅱ( P< 0 01).15 cases in group Ⅱ developed shivering before fetal birth compared with 4 in group Ⅰ( P< 0 01).Conclusions:Intrathecal morphine reduces shivering in parturients during cesarean section,especially before fetal birth.