单次小剂量吗啡用于剖宫产术后硬膜外镇痛的临床观察

目的对比研究单次小剂量吗啡用于剖宫产术后硬膜外镇痛的临床效果。方法剖宫产的产妇120例，采用持续硬膜外麻醉。依术后镇痛方法的不同，随机均分为3组。I组为舒芬太尼150μg、0．375％罗哌卡因5ml持续静脉自控镇痛；Ⅱ组为吗啡40μg／kg、0．375％罗哌卡因5ml；Ⅲ组为吗啡80μg／kg、0．375％罗哌卡因5ml。后两组采用单次硬膜外给药法。记录术后VAS和舒适评分（BCS），以及不良反应。结果3组产妇术后2、36、48hVAS和BCS评分差异无统计学意义；6、24hⅡ、Ⅲ组的VAS和BCS评分分别低于和高于I组（P〈0．05），Ⅱ、Ⅲ组间差异无统计学意义；Ⅲ组不良反应明显较Ⅰ、Ⅱ组多（P〈0．05）；Ⅱ组皮肤瘙痒发生率较I组高（P〈0．05），其他不良反应发生情况同Ⅰ组比较差异无统计学意义。结论吗啡40ug／kg单次用于剖宫产术后硬膜外镇痛效果确切、完善，不良反应发生率低。

Postoperative epidural analgesia with single small-dose morphine after caesarean section

Objective To investigate the efficacy of single small-dose morphine for postopera- tive epidural analgesia in parturients underwent cesarean section. Methods One hundred and twenty parturients under epidural block were randomly assigned into three group with 40 cases in each . The parturients in group Ⅰ received PCIA with sufentanil 150 μg and 0. 375% ropivacaine . The parturi- ents in group Ⅱreceived epidural analgesia with 0. 375% ropivacine and morphine 40 μg/kg, and those in group Ⅲ with 0. 375% ropivacaine and morphine 80 μg/kg. The visual analog scales（VAS） and Bruggmann comfort scale（BCS）were observed after operation. The adverse effects were observed during 48h after operation too. Results The VAS and BCS were no significant difference between three groups at 2,36 and 48 h; The VAS were signifieant lower in groupⅡ or Ⅲ than that in group I （P（0.05）, The BCS were significant higher in group Ⅱ or Ⅲ than that in group I （P〈0. 05）, but the VAS and BCS were no significant difference between group II and Ⅲ at 6 and 24 h. The adverse effects in group m were more than that in group Ⅰ ⅠorⅡ（P〈0.05） ,but that in group Ⅰ and Ⅱ were almost the same. Conclusion Postoperative epidural analgesia with single morphine 40 μg/kg after caesarean section has satisfactory effects and has no significant side effects.