硬膜外注入不同阿片类药物对剖宫产术后镇痛效果的比较

Comparison of epidural analgesia with different opioids after caesarean section

目的比较剖宫产术后不同阿片类药物联合低浓度罗哌卡因硬膜外镇痛的效果。方法择期行剖宫产术的孕妇60例，随机分为3组。术后A组硬膜外注入0．125％罗哌卡因10ml联合吗啡2mg，B组联合舒芬太尼5μg，C组联合芬太尼0．05mg。记录术后各时点VAS评分、运动阻滞程度和并发症。结果VAS评分术后9h时A组低于B组，B组低于C组（P〈0．05）；术后12h和24h时A组低于B组和C组（P〈0．05），B、C组间无统计学差异；运动阻滞程度和并发症各组间无统计学差异（P〉0．05）。结论硬膜外注射吗啡联合低浓度局麻药可增强镇痛效果，延长镇痛时间，是剖宫产术后有效的镇痛方法。

Objective To compare the epidural analgesic effect with different opioids and low concentration ropivacaine after caesarean section. Methods Sixty pregnant women were randomly divided into three groups： morphine 2 mg and 0. 125% ropivacaine 10 ml by epidural injection after the operation in group A; sufentanil 5 μg in group B; fentanyl 0.05 mg in group C. Visual analogue scale, the motor blockade and adverse reactions were recorded. Results VAS was the lowest in group A, lower in group B at 9 h after the operation. Compared with group B and C, VAS was low in group A at 12, 24 h after the operation. There were no differences in motor blockade quality and adverse reactions between groups. Conclusion Low concentration ropivacaine combined with morphine by epidural injection has a good analgesia effect for cesarean section with a longer analgesia time.