剖腹产术后阿片类药物单次硬膜外镇痛对尿潴留的影响  

Effects of epidural opioids on postpartum urinary retention in women undergoing cesarean delivery

作　　者：王志华[1] 陈勇[1] 欧阳碧山[1] 梁敏[1] 

机构地区：[1]海南省人民医院麻醉科,海南海口570311

出　　处：《海南医学》2012年第18期68-69,共2页Hainan Medical Journal

摘　　要：目的比较剖腹产术后舒芬太尼、芬太尼及吗啡单次硬膜外镇痛对患者术后尿潴留的影响。方法90例ASAⅠ～Ⅱ级择期硬膜外麻醉下剖腹产患者随机分为三组(n=30),夹闭胎儿脐带时,舒芬太尼组(S组)硬膜外腔给予舒芬太尼10μg(5ml),芬太尼组(F组)给予0.1mg芬太尼(5ml);吗啡组(M组)给予2mg吗啡(5ml)。所有患者术后8h拔除尿管。观察各组发生尿潴留例数,并记录各组患者的镇痛时间和术后并发症情况。结果M组有12例(40%)患者发生尿潴留,S组和F组分别为4例(13%)和3例(10%)。各组镇痛时间分别为3h(S组)、2h(F组)和12h(M组)。各组术后无一例患者发生呼吸抑制和神经并发症。结论剖腹产术后硬膜外单次注射吗啡比舒芬太尼和芬太尼更易产生尿潴留。Objective To determine the effects of epidural opioids regarding the incidence of postpartum urinary retention （PUR） in women undergoing elective cesarean delivery. Methods 90 ASA I or II patients undergoing caesarean section （C/S） with epidural 2% lidocaine were randomized into three groups： Sufentanil group （S group）, Fentanyl group （F group） and Morphine group （M group）. The patients in the three groups received 10 ug sufentanil （S）, 0.l mg fentanyI （F） and 2 mg morphine （M） epidurally immediately after delivery, respectively. Bladder catheters were removed 8 hours postpartum, and the incidence of postpartum urinary retention, and analgesic duration was recorded. Results Twelve （40%） patients in M group suffered PUR, while the incidence of PUR was significantly low- er in group S （4 cases, 13%） and group F （3 cases, 10%）. The analgesic duration for the three groups were 3 h, 2 h and 12 h, respectively. Conclusion The incidence of PUR was significantly lower with epidural sufentanil and femanyl, as compared with epidural morphine in women undergoing cesarean.

关 键 词：舒芬太尼 硬膜外 镇痛 剖宫产 

分 类 号：R694.55[医药卫生—泌尿科学]