摘要
目的探讨2.5 mg吗啡联合布托啡诺对剖宫产产妇术后镇痛效果及应激反应影响。方法纳入2023年1月至12月入院的90例剖宫产产妇作为研究对象进行回顾性分析。根据麻醉后镇痛药物的不同将90例产妇分为对照组(45例,接受布托啡诺自控静脉镇痛)和观察组(45例,接受2.5 mg吗啡联合布托啡诺自控静脉镇痛)。对比2组术后镇痛效果[视觉模拟评分法(VAS)、Ramsay镇静评分法、舒适评分(BCS)]、术后应激反应[皮质醇(COR)、血管紧张素Ⅱ(AngⅡ、肾上腺素(E)、去甲肾上腺素(NE)]、术后泌乳情况(产后开奶时间、泌乳开始时间以及48 h内哺乳次数)、术后并发症发生情况(嗜睡、头晕、恶心呕吐、寒战、幻觉)。结果T1、T2、T3、T4时刻,观察组VAS评分均低于对照组,观察组Ramsay评分、BCS评分均高于对照组(均P<0.05)。T1、T4时刻,观察组COR、AngⅡ、E、NE指标水平均低于对照组(P<0.05)。观察组产后开奶时间、泌乳开始时间短于对照组,观察组48 h内哺乳次数多于对照组(均P<0.05)。2组嗜睡、头晕、恶心呕吐、寒战、幻觉等并发症总发生率比较差异无统计学意义(P>0.05)。结论2.5 mg吗啡联合布托啡诺用于剖宫产产妇术后镇痛,可提升镇痛效果,减轻术后应激反应,促进术后泌乳功能提升,并不会增加并发症发生风险。
Objective To investigate the effects of 2.5 mg morphine combined with butorphanol on analgesia and stress response after cesarean section.Methods A retrospective analysis was conducted on 90 cesarean section parturients admitted from January 2023 to December 2023.According to the different postoperative analgesic drugs used,90 patients were divided into a control group(n=45,receiving butorphanol self-controlled intravenous analgesia)and an observation group(n=45,receiving 2.5 mg morphine combined with butorphanol self-controlled intravenous analgesia).Compare postoperative analgesic effects between two groups[visual analog scale(VAS),ramsay sedation scale,bruggrmann comfort scale(BCS)],postoperative stress response[cortisol(COR),angiotensinⅡ(AngⅡ),epinephrine(E),norepinephrine(NE)],postoperative lactation status(postpartum lactation start time,lactation start time,and number of breastfeeding within 48 hours),and incidence of postoperative complications(drowsiness,dizziness,Nausea,vomiting,chills,hallucinations).Results At T1,T2,T3,and T4,the VAS score of the observation group was lower than that of the control group.The Ramsay score and BCS score of the observation group were higher than that of the control group,all P<0.05.At T1 and T4,the levels of COR,AngⅡ,E,and NE in the observation group were lower than those in the control group(P<0.05).The postpartum milk opening time and lactation start time of the observation group were shorter than those of the control group,and the lactation times within 48 h of the observation group were more than those of the control group,all P<0.05.The total incidence of sleepiness,dizziness,nausea and vomiting,chills,and hallucinations were compared between the two groups and there were no significant differences(P>0.05).Conclusion 2.5 mg morphine combined with butorphanol can improve the analgesic effect after cesarean section,reduce the postoperative stress reaction,promote the improvement of postoperative lactation function,and not increase the risk of complications.
作者
张倩
丁远明
黄淑花
Zhang Qian;Ding Yuanming;Huang Shuhua(Department of Anesthesiology,Guizhou Staff Hospital,Guiyang 550025,China;不详)
出处
《山西医药杂志》
2025年第1期41-45,共5页
Shanxi Medical Journal
关键词
剖宫产术
吗啡
布托啡诺
镇痛
应激反应
Cesarean section
Orphine
Butorphanol
Analgesia
Stress response
