剖宫产硬膜外腔单次注射吗啡联合舒芬太尼静脉自控镇痛对产后抑郁的影响  

Effect of Single Epidural Injection of Morphine Combined with Sufentanil Patient-Controlled Intravenous Analgesia During Cesarean Section on Postpartum Depression

作　　者：杜顺颜[1] 林金兵[1] 邓爱红[1] 梁肖霞[1] 洪钦政[1] Du Shunyan;Lin Jinbing;Deng Aihong;Liang Xiaoxia;Hong Qinzheng(Department of Anesthesiology,The Second People＇s Hospital of Foshan,Foshan,Guangdong,China 52800)

机构地区：[1]广东省佛山市第二人民医院麻醉科,广东佛山528000

出　　处：《中国药业》2018年第17期69-71,共3页China Pharmaceuticals

基　　金：广东省佛山市卫生和计生局医学科研项目[20160122]

摘　　要：目的探讨硬膜外腔单次注射吗啡联合舒芬太尼静脉自控镇痛对剖宫产产后抑郁的影响。方法选取2016年11月至2017年11月在医院行剖宫产的产妇80例,随机分为对照组和研究组,各40例。对照组产妇采取硬膜外腔单次注射吗啡,研究组产妇采取硬膜外腔单次注射吗啡联合舒芬太尼静脉自控镇痛。结果两组产妇术后24 h视觉模拟评分(VAS)比较,差异无统计学意义(P>0.05);研究组术后48 h明显低于对照组,差异有统计学意义(P<0.01)。对照组和研究组哺乳后24 h和48 h的新生儿神经行为评分(NBNA评分)比较,差异均无统计学意义(P>0.05)。两组产妇麻醉前的5-羟色胺水平比较,差异无统学意义(P>0.05),研究组术后24 h和72 h明显低于对照组(P<0.05)。对照组爱丁堡产后抑郁量表(EPDS)总分为(20.79±2.88)分,明显高于研究组的(14.88±2.90)分(P<0.01)。对照组不良反应发生率为15.00%,与研究组的10.00%比较,差异无统计学意义(P>0.05)。结论硬膜外腔单次注射吗啡联合舒芬太尼静脉自控镇痛,可显著提高剖宫产术后的麻醉效果,并能在不影响新生儿神经行为和不增加不良反应的情况下,降低产后抑郁程度,促进产妇早日恢复。Objective To investigate the effect of single epidural injection of morphine combined with sufentanil patient- controlled intravenous analgesia on epidural anesthesia in cesarean section and postpartum depression. Methods Totally 80 parturient women undergoing cesarean section admitted to our hospital from November 2016 to November 2017 were randomly divided into the control group and the study group, 40 cases in each group. The control group was given single epidural injection of morphine, while the study group was given single epidural injection of morphine combined with sufentanil patient- controlled intravenous analgesia. Results 24 h after operation, there was no significant difference in VAS score between the two groups（P 〉 0. 05）, and that in the study group was significantly higher than that in the control group at 48 h after operation（P 〈 0.01）.24,48 h after lactation, there was no significant difference in NBNA scores between the control group and the study group（P 〉 0. 05）. Before anesthesia, there was no significant difference in 5- hydroxytryptamine of the two groups（P 〉 0.05）, but that in the study group was significantly lower than that in the control group at 24, 72 h after operation（P 〈 0. 05）. After childbirth, the total score of EPDS in the control group was （20. 79±2.88） points, which was significantly higher than （14.88 ±2. 90） points in the study group（P 〈 0.05）. The incidence rate of adverse reactions in the control group was 15.00%, which was not significantly different from 10. 00% in the study group（P 〉 0. 05）. Conclusion Single epidural injection of morphine combined with sufentanil patient- controlled intravenous analgesia can significantly improve anesthesia effect after cesarean section, and it can reduce the degree of postpartum depression and promote the early recovery of the parturient women without affecting the neonatal neurobehavior and increasing adverse reactions.

关 键 词：吗啡 舒芬太尼 剖宫产 产后抑郁 

分 类 号：R969.4[医药卫生—药理学] R971.1[医药卫生—药学]