布比卡因复合小剂量吗啡单次腰麻在剖宫产手术中应用的研究

Application of bupivacaine combined with low-dose morphine in single spinal anesthesia in cesarean section

目的 探讨布比卡因复合小剂量吗啡单次腰麻在剖宫产手术中的应用效果.方法 将湘潭县人民医院2019年10月-2019年12月期间收治的104例剖宫产产妇分组.按照随机数字表法分为对照组52例,给予布比卡因单次腰麻,观察组52例采用布比卡因复合小剂量吗啡单次腰麻.观察两组心率与血压、镇痛效果、麻醉效果及术后不良反应.结果 术前,两组产妇MAP、HR对比无统计学差异(P>0.05),麻醉起效后5分钟、10分钟时,观察组MAP、HR值均低于对照组(P<0.05);术后1h、术后4h、术后12h,观察组VAS量表分值均低于对照组(P<0.05);观察组麻醉优良率(94.23%)高于对照组(78.85%)(P<0.05);观察组不良反应(腰背痛、切口痛、恶心呕吐)发生率(15.38%)与对照组(11.54%)比较,无统计学差异(P>0.05).结论 布比卡因复合小剂量吗啡单次腰麻应用于剖宫产手术,可显著降低心率与血压,提高镇痛及麻醉效果,且不会增加术后不良反应.

Objective To investigate the application of bupivacaine combined with low-dose morphine single-shot spinal anesthesia in cesarean section.Methods A total of 104 cesarean section women in our hospital from October 2019 to December 2019 were divided into groups.According to the random number table method,52 cases in the control group were given a single spinal anesthesia with bupivacaine,and 52 cases in the observation group were given a single spinal anesthesia with bupivacaine combined with low-dose morphine.The heart rate and blood pressure,analgesic effect,anesthesia effect and postoperative adverse reactions were observed in the two groups.Results Before operation,there was no significant difference in MAP and HR between the two groups(P>0.05),and 5 minutes and 10 minutes after the onset of anesthesia,the MAP and HR values were lower than those in the control group(P<0.05);at 1h,4h,and 12h after operation,the VAS scale scores of the observation group were lower than those of the control group(P<0.05);the excellent and good rate of anesthesia in the observation group(94.23%)was higher than that in the control group(78.84%)(P<0.05);there was no significant difference in the incidence of adverse reactions(low back pain,incision pain,nausea and vomiting)between the observation group(15.38%)and the control group(11.54%)(P>0.05).Conclusions Bupivacaine combined with low-dose morphine single-shot spinal anesthesia applied to cesarean section can significantly reduce heart rate and blood pressure,improve analgesia and anesthesia effect,and will not increase postoperative adverse reactions.