布托啡诺联合格拉司琼对鞘内注射吗啡镇痛期皮肤瘙痒的影响

Effect of combined use of butorphanol and granisetron on morphine-induced pruritus during intrathecal analgesia

目的观察布托啡诺联合格拉司琼对鞘内注射吗啡术后镇痛期皮肤瘙痒的影响。方法鞘内注射吗啡0.1mg行术后镇痛的剖宫产妇160例随机均分为四组,于胎儿脐带夹闭后分别静脉注射布托啡诺2mg/2ml(B组)、格拉司琼3mg/3ml(G组)、布托啡诺2mg/2ml和格拉司琼3mg/3ml(BG组),C组注射生理盐水作对照。记录术后12h镇痛期内皮肤瘙痒程度和不良反应发生情况。结果 BG组瘙痒的发生率低于C组(17.5%vs.47.5%)(P<0.05);BG组在1、4和8h时的瘙痒程度和B组在8h时的瘙痒程度较C组轻(P<0.05)。四组患者术后恶心呕吐、头晕、眼花、寒战等其他不良反应发生情况相仿(P>0.05)。结论布托啡诺联合格拉司琼可以显著减少吗啡镇痛期瘙痒的发生率和瘙痒程度。

Objective To investigate the effect of combined use of butorphanol and granisetron on morphine-induced pruritus during intrathecal analgesia. Methods Intrathecal analgesia with morphine 0. 1 nag was performed in 160 women undergoing Cesarean section,who were randomly and equally assigned into 4 groups of B （butorphanol 2 mg/2 ml）, G （granisetron 3 mg/3 ml）, BG（butorphanol 2 mg/2 ml plus granisetron 3 mg/3 ml） and C（normal saline alone as the control）. All drugs were injected intravenously soon after the umbilical cord was clamped. The incidence and severity of pruritus at 1,4,8,10 and 12 h after intrathecal morphine administration were evaluated. Results The incidence of pruritus was less in group BG than that in group C（17.5% vs. 47.5%） （P〈0. 05）. The severity of pruritus at 1,4 and 8 h was slighter in group BG than that in group C （P〈0. 05）. The severity of pruritus at 8 h was also lower in group B than that in group C（P〈0. 05）. There were no significant differences in nausea/vomiting and other adverse effects among 4 groups. Conclusion Combined use of granisetron and butorphanol can effectively reduce the incidence and severity of intrathecal morphine-induced pruritus.