摘要
目的:考察罗哌卡因联合吗啡用于剖宫产术后镇痛效果。方法:选择ASAⅠ～Ⅱ级择期或急诊剖宫产孕妇,行剖宫产产妇126例,随机为两组:罗哌卡因组60例和罗哌卡因联合吗啡组66例。罗哌卡因联合吗啡组术后给予罗哌卡因联合吗啡持续镇痛36 h,罗哌卡因组采用罗哌卡因续镇痛,分别记录两组患者术后36 h内的收缩压、心率、血氧饱和度及术后疼痛评分,并记录患者恶心、呕吐、皮肤瘙痒以及肛门排气和下床时间。结果:在硬膜外镇痛开启时两组收缩压、心率、血氧饱和度比较,差异无统计学意义(P>0.05),开启后除SpO2外,收缩压和心率组内比较都有不同程度降低,差异有统计学意义(P<0.05)。与罗哌卡因组比,罗哌卡因联合吗啡组收缩压、心率显著降低。两组在硬膜外镇痛开启时,VAS和Bromage评分差异无统计学意义(P>0.05),开启后两个组别的VAS和Bromage评分有所升高,与罗哌卡因组比,罗哌卡因联合吗啡组6～36 h的VAS和Bromage评分显著降低,差异有统计学意义(P<0.05)。两个组别病患术后宫缩、子宫复归、恶露量在正常范围。与罗哌卡因组比,罗哌卡因联合吗啡组肛门排气时间,下床时间显著缩短,差异有统计学意义(P<0.05)。罗哌卡因联合吗啡组术后无明显的不良反应。结论:经硬膜外腔给予罗哌卡因联合吗啡是一种安全、有效的方法,适用于剖宫产术后镇痛。
Objective To test the analgesia effect of ropivaeaine combined with morphine after cesarean section. Method The pregnant women who from March 2005 to November 2010 in our hospital obstetric ASA Ⅰ-Ⅱ underwent elective or emergency cesarean section were randomly separated into two groups：ropivacaine combined with morphine group （66 cases） and the ropivacaine group （60 cases）. The ropivacaine combined with morphine group was given ropivacaine combined with morphine for 36h continuous analgesia. The other group was only given ropivaeaine. VAS and Bromage score, SBP （ Systolic Blood Pressure ）, HR （ Heat Rate） and Sp02, nausea, vomiting, pruritus, anal exhaust and getting out of bed time were recorded. Results Before epidural analgesia,SBP,HR and SpO2 of 2 groups had no statistical differences （ P 〉 0. 05 ）. During epidural analgesia, SpO2 in 2 groups had no statistical difference （ P 〉 0. 05 ）. SBP and HR were decreased （ P 〈 0. 05 ）. Compared with ropivacaine group, SBP and HR decreased significantly in ropivacaine combined with morphine group （ P 〉 0. 05）. VAS and Bromage scores showed no significant difference before epidural analgesia （P 〉 0. 05）. During epidural analgesia, VAS and Bromage score in two groups increased （P 〈 0. 05 ）. Compared with ropivacaine group, VAS and Bromage score decreased significantly in ropivacaine combined with morphine group （ P 〈 0. 05 ）. Uterine contraction, uterine involution and lochia volume were normal within two groups. Compared with ropivacaine group, anal exhaust time and time of getting out of bed in ropivacaine combined with morphine were sig- nificantly shortened （ P 〈 0. 05 ）. Conclusion Ropivacaine combined with morphine is a safe, effective method, suitable for analgesia after cesarean section.
出处
《吉林医学》
CAS
2013年第25期5145-5147,共3页
Jilin Medical Journal
关键词
罗哌卡因
吗啡
剖宫产
镇痛
Ropivacaine Cain
Morphine
Cesarean Section
Analgesic
