小剂量吗啡鞘内注射用于剖宫产的术后镇痛的研究

Intrathecal Less Dose Morphine for Postoperative Analgesia After Cesarean-section

目的观察小剂量吗啡鞘内注射对于剖宫产术后镇痛的效果及其不良反应。方法随机选择ASA I^II级足月妊娠的剖宫产产妇75例,年龄22~30岁。其中15例使用静脉镇痛泵为镇痛泵组(B组),15例无术后镇痛为对照组(D组),45例行小剂量吗啡鞘内注射为鞘内注射组(Q组);其中Q组再随机分为3组,每组15例:100μg吗啡组(Q100组),200μg吗啡组(Q200组)和400μg吗啡组(Q400组)。这75例产妇均在腰硬联合麻醉下完成剖宫产手术。观察对婴儿Apgar评分的影响,镇痛效果及不良反应。结果 3组婴儿1 min和5 min Apgar评分结果无统计学意义(P>0.05)。在镇痛效果上,B组和Q200组,Q400组镇痛效果好,Q100组、Q200组与对照组相比较术后发生不良反应事件无统计学意义(P>0.05);Q400组术后发生不良反应事件增多(P<0.05)。结论小剂量吗啡200μg鞘内注射基本满足剖宫产术后镇痛,是一种安全有效经济的术后镇痛方法。

Objective To observed the effect of intrathecal less dose morphine for postoperative analgesia after cesarean-section. Methods 75 cases of fullterm pregnancy by cesarean section of ASA Ⅰ~Ⅱ were chosen randomly,age distribution 22 ~ 30 y based on random distribution function,and 15 cases with venous analgesic pump as analgesic pump group（B group）,15 cases with no postoperative analgesia as control group（D group）,45 cases with intrathecal less dose morphine as intrathecal injection group（Q group）,then,Q group were randomly divided into three groups,15 cases in each ：100 μg morphine（Q100 group）,200 μg morphine（Q200 group） 和 400 μg morphine（Q400 group）,75 cases were cesarean section under combined spinal-epidural anesthesia. Observation the on Apgar score,analgesic effects,and adverse reactions of neonates. Results1 min and 5 min Apgar score in three group had no statistically significant difference（P 0.05）. B group,Q200 group,Q400 group had effective anesthetic,compared with the control group,postoperative adverse reaction of Q100 group,Q200 group had no significant difference（P 0.05）. Postoperative adverse reaction significant increase in Q400 group（P 0.05）. Conclusion Intrathecal less dose morphine 200 μg basically meets postoperative analgesia.