西藏藏族产妇剖宫产术后硬膜外吗啡所致瘙痒反应的临床观察

Clinical observation of epidural morphine-induced pruritus in Tibetan parturients after cesarean section

目的:旨在研究西藏藏族产妇的硬膜外吗啡所致瘙痒(epidural morphine induced pruritus,EMIP)的临床特点。方法:这是一项前瞻性单中心临床观察研究。选取西藏藏族接受剖宫产的产妇作为研究对象,在吗啡给药后3 h、6 h、12 h、24 h、48 h进行随访评估。首要结局指标是EMIP发病率。此外,还记录瘙痒的发生、持续时间和部位等其他信息。结果:共有17名受试者入选,全部完成临床观察。其中2名产妇发生EMIP。EMIP产妇主要症状为头面部、胸腹部瘙痒,其瘙痒症状分别出现于吗啡给药后16 h与2 h,瘙痒持续时间分别为24 h与3 h。结论:本研究发现西藏藏族产妇EMIP发生率为11.8%,而西藏藏族产妇EMIP可能的危险因素有待积累更多数据进一步探讨。

Objective: The purpose of this study was to find the clinical characteristics of epidural morphineinduced pruritus(EMIP) in Tibetan parturients. Methods: This was a prospective single-center clinical observational study. Follow-up evaluations were performed at 3, 6, 12, 24 and 48 hours after morphine administration. The primary outcome was the incidence of EMIP. In addition, the occurrence, duration and location of pruritus were recorded. Results: A total of 17 subjects were selected and all completed the clinical observation. Two of them had EMIP. The main symptoms of EMIP patients were pruritus on the head, face, chest and abdomen. The pruritus symptoms emerged at 16 and 2 hours after morphine administration, lasting 24 and 3 hours, respectively. Conclusion: This study found that the incidence of EMIP among parturients in Tibet was 11.8%. The possible risk factors of EMIP among Tibetan parturients need to be further explored by accumulating more data.