微剂量吗啡鞘内注射用于剖宫产镇痛40例

目的 观察微剂量吗啡鞘内注射辅助镇痛用于剖宫产的效果及不良反应.方法 选取美国麻醉医师协会(ASA)分级Ⅰ或Ⅱ级、足月妊娠剖宫产产妇120例,随机均分为A组、B组和C组,麻醉方式均为腰硬联合麻醉.药物为0.75%布比卡因1.2 mL+0.6 mL生理盐水蛛网膜下腔阻滞,术后用硬膜外罗哌卡因镇痛.3组生理盐水内含吗啡剂量分别为A组0.12 mg、B组0.08 mg、C组0 mg(对照组).观察新生儿Apgar评分,术后4,8,12,24 h时镇痛效果及呼吸抑制、恶心呕吐、皮肤瘙痒等不良反应.结果 A组、B组术后8 h内镇痛效果明显优于C组(P<0.01),B组皮肤瘙痒发生率显著低于A组(P<0.05),3组新生儿Apgar评分差异无统计学意义.结论 0.08mg吗啡鞘内注射辅助镇痛用于剖宫产,效果满意,且术后并发症少.

Intrathecal Injection of Microdose Morphine in 120 Cases of Cesarean Section

Objective To observe the effect and adverse reactions of intrathecal injection of microdose morphine for auxiliary analgesia in cesarean section. Methods A hundred and twenty full- term pregnancy puerperas with cesarean section, the ASA Ⅰ or Ⅱ level, were randomly divided into three groups. All cases received combined and epidural anesthesia. Zero point five percent bupivacaine 1.2 mE plus normal saline 0. 6 mL were given for subarachnoid block and epidural ropivacanine for postoperative analgesia. The morphine doses contained in normal saline were 0. 12 mg in the group A, 0.08 mg in the group B and 0 mg in the C group as control group. The Ap- gar scores in newborns, analgesic effects at postoperative 4, 8, 12, 24 h and adverse reactions such as respiratory inhibition, nausea vomit- ing and itchy skin were observed among the groups. Results The analgesic effects within postoperative 8 h in the group A and B were much better than the group C （P 〈 0. 01）. The incidence rate of itchy skin in the group B was significantly lower than that in the group A （P 〈0. 05）. The neonatal Apgar scores had no statistical difference among 3 groups. Conclusion Morphine 0. 08 mg by intrathe- cal injection for auxiliary analgesia in cesarean section has satisfactory effect and less postoperative complications.