硬膜外注射吗啡用于缓解侧切产妇产后会阴部疼痛的效果

发布时间：2018-05-09 07:03

  本文选题：吗啡 + 侧切　； 参考：《临床麻醉学杂志》2017年09期

【摘要】：目的观察硬膜外注射吗啡缓解侧切产妇产后会阴部疼痛的有效性。方法选择要求自然分娩且经历侧切的产妇145例,随机分为三组,脐带结扎后硬膜外分别给予内含1 mg吗啡(M1组)或2mg吗啡(M2组)的生理盐水10ml,或单纯生理盐水10ml(C组)。随访记录产妇产后24h内静息和活动状态现实疼痛强度(present pain intensity,PPI)及活动时PPI中重度疼痛出现时间;同时记录吗啡相关不良反应。结果静息状态PPI中重度疼痛的比例M2组(2.1%)明显低于M1组(15.7%)和C组(19.1%)(P0.05);活动状态PPI中重度疼痛出现时间M2组(15.7±1.4)h明显晚于M1组(11.0±0.9)h和C组(11.0±1.0)h(P0.05)。然而,恶心、呕吐、瘙痒、尿潴留的累积发生率M2组(102.1%)明显高于M1组(43.1%)和C组(12.8%)(P0.05)。结论脐带结扎后硬膜外注射2mg吗啡虽然显著减低产妇静息PPI中重度疼痛的比例并推迟活动时PPI中重度疼痛的出现时间,但是增加了不良反应发生率,需慎重使用。
[Abstract]:Objective to observe the effectiveness of epidural morphine injection in relieving postpartum perineal pain in parturient. Methods one hundred and forty-five parturients who had undergone side cutting were randomly divided into three groups. After ligation of umbilical cord, normal saline (10 ml) or 2mg morphine (M2 group) were given epidural administration after ligation of umbilical cord (1 mg morphine) or 10ml(C alone. Postpartum women were followed up to record the time of occurrence of moderate and severe pain in PPI during 24 hours postpartum and the time of occurrence of moderate and severe pain in PPI, and to record the side effects associated with morphine at the same time. Results the proportion of moderate and severe pain in resting PPI in group M2 was significantly lower than that in group M 1 (15.7g) and group C was 19.1g / P 0.05.The time of occurrence of moderate and severe pain in group M2 was 15.7 卤1.4 hours later than that in group M1 (11.0 卤0.9h) and group C (11.0 卤1.0hP0.05). However, the cumulative incidence of nausea, vomiting, itching, and urinary retention in group M2 (102.1) was significantly higher than that in group M1 (43.1) and group C (12.8m). Conclusion epidural injection of 2mg morphine after umbilical cord ligation can significantly reduce the proportion of moderate and severe pain in resting PPI and delay the onset time of moderate and severe pain in PPI, but it increases the incidence of adverse reactions and needs careful use.
【作者单位】： 南京医科大学附属南京妇产医院麻醉科;
【基金】：南京医科大学科技发展基金面上项目(2014NJMU091) 江苏省科技厅临床医学专项项目(BL2014016)
【分类号】：R614
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本文编号：1865050