本文選題：嗎啡 + 側(cè)切��； 參考：《臨床麻醉學(xué)雜志》2017年09期

【摘要】：目的觀察硬膜外注射嗎啡緩解側(cè)切產(chǎn)婦產(chǎn)后會(huì)陰部疼痛的有效性。方法選擇要求自然分娩且經(jīng)歷側(cè)切的產(chǎn)婦145例,隨機(jī)分為三組,臍帶結(jié)扎后硬膜外分別給予內(nèi)含1 mg嗎啡(M1組)或2mg嗎啡(M2組)的生理鹽水10ml,或單純生理鹽水10ml(C組)。隨訪記錄產(chǎn)婦產(chǎn)后24h內(nèi)靜息和活動(dòng)狀態(tài)現(xiàn)實(shí)疼痛強(qiáng)度(present pain intensity,PPI)及活動(dòng)時(shí)PPI中重度疼痛出現(xiàn)時(shí)間;同時(shí)記錄嗎啡相關(guān)不良反應(yīng)。結(jié)果靜息狀態(tài)PPI中重度疼痛的比例M2組(2.1%)明顯低于M1組(15.7%)和C組(19.1%)(P0.05);活動(dòng)狀態(tài)PPI中重度疼痛出現(xiàn)時(shí)間M2組(15.7±1.4)h明顯晚于M1組(11.0±0.9)h和C組(11.0±1.0)h(P0.05)。然而,惡心、嘔吐、瘙癢、尿潴留的累積發(fā)生率M2組(102.1%)明顯高于M1組(43.1%)和C組(12.8%)(P0.05)。結(jié)論臍帶結(jié)扎后硬膜外注射2mg嗎啡雖然顯著減低產(chǎn)婦靜息PPI中重度疼痛的比例并推遲活動(dòng)時(shí)PPI中重度疼痛的出現(xiàn)時(shí)間,但是增加了不良反應(yīng)發(fā)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 鹵1.4 hours later than that in group M1 (11.0 鹵0.9h) and group C (11.0 鹵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.
【作者單位】： 南京醫(yī)科大學(xué)附屬南京婦產(chǎn)醫(yī)院麻醉科;
【基金】：南京醫(yī)科大學(xué)科技發(fā)展基金面上項(xiàng)目(2014NJMU091) 江蘇省科技廳臨床醫(yī)學(xué)專項(xiàng)項(xiàng)目(BL2014016)
【分類號(hào)】：R614
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本文編號(hào)：1865050