盐酸羟考酮用于剖宫产术后静脉自控镇痛的疗效及对血泌乳素的影响  

Effects of patient-controlled intravenous analgesia with oxycodone hydrochloride on the postcesarean delivery pain relief and serum prolactin level

作　　者：张骐 崔雯 

机构地区：[1]芜湖市第二人民医院麻醉科,安徽芜湖241000

出　　处：《皖南医学院学报》2016年第3期283-285,共3页Journal of Wannan Medical College

摘　　要：目的：比较盐酸羟考酮与吗啡用于剖宫产术后静脉自控镇痛的效果及对血泌乳素的影响。方法：行择期剖宫产术的产妇80例,年龄21~36岁,随机分为盐酸羟考酮组（Q组）及吗啡组（M组）,每组各40例。两组产妇均行腰硬联合麻醉,术毕连接静脉自控镇痛泵,Q组药物为盐酸羟考酮注射液30 mg＋托烷司琼3 mg＋0.9%氯化钠注射液100 m L,M组为吗啡30mg＋托烷司琼3 mg＋0.9%氯化钠注射液100 m L,背景液量2 m L/h,单次给药0.5 m L,锁定时间15 min。分别记录两组产妇术后1 h、6 h、12 h、24 h、48 h的VAS镇痛评分及宫缩镇痛评分。放射免疫法检测两组产妇麻醉前、术后24 h、48 h血浆泌乳素（PRL）含量,并观察产妇48 h内初乳时间及恶心、呕吐、皮肤瘙痒等不良反应,最后对两组数据进行统计学分析。结果：两组产妇各时点VAS评分比较,术后1 h时Q组VAS评分明显低于M组,差异有统计学意义（P〈0.05）;此后两组VAS评分差异无统计学意义（P〉0.05）;两组产妇宫缩VAS评分比较,Q组各时间点宫缩VAS评分较M组低,差异有统计学意义（P〈0.05）;两组血泌乳素水平比术前有明显提高;两组产妇不良反应比较,M组恶心呕吐及皮肤瘙痒的发生率明显高于Q组,差异有统计学意义（P〈0.05）。结论：盐酸羟考酮注射液与吗啡自控镇痛均有良好的切口痛镇痛效果,但羟考酮在减轻宫缩痛方面明显优于吗啡,且不良反应少,可以提高产妇术后的母乳喂养成功率。Objective： To observe the effects of patient-controlled intravenous analgesia with oxycodone hydrochloride or morphine on the post-cesarean delivery pain relief and serum prolactin level. Methods： Eighty women（ aged 21- 36 years）,scheduled for elective cesarean section,were included and equally randomized into group Q and M. Patients in the two groups generally underwent spinal-epidual anesthesia,and were offered patient-controlled analgesia device for pain control after surgery. Group Q were administered with oxycodone hydrochloride injection（ 30mg） ＋ tropisetron（ 3mg） ＋ 0. 9% sodium chloride injection（ 100 m L）,and group M with morphine（ 30 mg） ＋ tropisetron（ 3 mg） ＋ 0. 9% sodium chloride injection（ 100 m L）. Background infusion was set by 2 m L / h,single dose of 0. 5 m L and lockout interval at 15 min. Visual Analogue Scales（ VAS） was used to assess the incisional pain and that from uterine contractions at 1 h,6 h,12 h,24 h and 48 h after operation. Blood was obtained from the two groups of puerperae before anesthesia,postoperative 24 h and 48 h,respectively,and determined for the serum prolactin level by radioimmunoassay. Mothers in the two groups were also observed concerning secretion of colostrums in 48 h and adverse reactions,including nausea,vomiting and itchy skin after cesarean birth. All data were statistically analyzed and compared between the two groups. Results： Group Q had significantly lower score on VAS than group M during postoperative 1 h（ P〈0. 05）,yet the two groups remained no difference at remaining time points（ P〈0. 05）. Incisional pain from uterine contractions on VAS scores was lower in group Q than that in group M regarding each time point（ P〈0. 05）. Markedly elevated serum prolactin level was observed in the two groups,whereas group M had higher incidences of nausea and itchy skin（ P〈0. 05）. Conclusion： Patient-controlled intravenous analgesia with oxycodone hydrochloride plus morphine may lead to better control o

关 键 词：盐酸羟考酮 剖宫产 镇痛 血泌乳素 

分 类 号：R614[医药卫生—麻醉学] R719.8[医药卫生—外科学]