硬膜外腔注射吗啡—甲氧氯普胺对妇产科患者术后镇痛及并发症的观察

Epidural Morphine and Metoclopramide Injection for the Pain Relief and the Evaluation of its Complications in the Gynecological and Obstetric Patients

目的 :观察硬膜外腔注射吗啡 甲氧氯普胺对妇产科患者术后镇痛的疗效及并发症。方法 :在硬膜外阻滞下行妇产科手术的患者 30 0例 ,随机分为 :①吗啡 甲氧氯普胺组 :15 0例 ,硬膜外腔注射吗啡 2mg ,甲氧氯普胺 2 0mg( 0 .9%氯化钠注射液稀释至 10mL) ;②单独吗啡组 :15 0例 ,硬膜外腔注射吗啡 2mg( 0 .9%氯化钠注射液稀释至 10mL)。观察两组镇痛效果、维持时间、并发症 (恶心、呕吐及尿潴留 )及胃肠功能恢复时间。结果 :两组镇痛效果、镇痛维持时间均无统计学差异 ,吗啡 甲氧氯普胺组恶心、呕吐发生率明显低于单纯吗啡组 (P <0 .0 1) ,胃肠功能恢复时间也短于单纯吗啡组 (P <0 .0 1)。结论 :甲氧氯普胺

Objective: To evaluate the effect and complications of epidural injection of morphine and metoclopramide for the postoperative pain relief in gynecological and obstetric patients.Method: 300 gynecological and obstetric patients with epidural anesthesia were divided into two groups randomly: 150 in combined morphine and metoclopramide group with morphine 2mg and metoclopramide 20mg injected into epidural space (diluted to 10 mL with normal saline ); 150 in single morphine group with morphine 2 mg injected into epidural space (diluted to 10 mL with normal saline). The effect of pain relief, duration of pain relief, complications (nausea, vomiting and urine retention), and the recovery time of gastrointestinal function were evaluated between the two groups. Result: There was no statistical difference regarding the pain relief and duration of pain relief between the two groups, the incidence rate of nausea and vomiting in morphine and metoclopramide groups was much fewer ( P < 0.01 ) whilst the recovery time of gastrointestinal function was shorter than that in single morphine group( P < 0.01 ).Conclusion: Metoclopramide morphine can reduce the complications of the postoperative pain relief in gynecological and obstetric patients.