不同剂量氢吗啡酮在剖宫产术后硬膜外自控镇痛中的效果观察  

Observation on the Effect of Different Doses of Hydromorphone in Patient-Controlled Epidural Analgesia After Cesarean Section

作　　者：韩天福 张姣 罗洁荣 郑彬[1] 刘焕仪[1] HAN Tianfu;ZHANG Jiao;LUO Jierong;ZHENG Bin;LIU Huanyi(Surgical Anesthesia Center,Guangzhou First People's Hospital,Guangzhou 510030,China)

机构地区：[1]广州市第一人民医院手术麻醉中心,广东广州510030

出　　处：《临床医学工程》2020年第12期1713-1714,共2页Clinical Medicine & Engineering

摘　　要：目的观察不同剂量氢吗啡酮在剖宫产术后硬膜外自控镇痛中的镇痛效果及不良反应。方法选取2019年3月至2019年8月于我院行剖宫产的产妇90例,随机分为三组各30例。术后给予氢吗啡酮联合罗哌卡因硬膜外自控镇痛,A、B、C组的氢吗啡酮剂量分别为2mg、1.5mg、1 mg。比较三组术后4h、8h、12h、24h静息、活动、按摩子宫的VAS评分及不良反应。结果三组术后4h、8h、12h、24h静息、活动、按摩子宫的VAS评分比较,差异无统计学意义(P>0.05),但三组按摩子宫的VAS评分均较高;C组的自控按压次数显著多于A组(P<0.05)。三组均未出现呼吸抑制和镇静过度,三组的恶心、呕吐、头晕发生率比较,差异无统计学意义(P>0.05);C组的皮肤瘙痒发生率显著低于A组和B组(P<0.05)。结论1 mg氢吗啡酮联合罗哌卡因应用于剖宫产术后硬膜外自控镇痛的效果好,不良反应少,值得临床应用。Objective To observe the analgesic effects and adverse reactions of different doses of hydromorphone in patient-controlled epidural analgesia after cesarean section.Methods A total of 90 parturient women with cesarean section in our hospital from March 2019 to August 2019 were selected and randomly divided into three groups,with 30 cases in each group.After surgery,all cases received hydromorphone combined with ropivacaine for patient-controlled epidural analgesia.The doses of hydromorphone in group A,B and C were 2 mg,1.5 mg and 1 mg,respectively.4 h,8 h,12 h and 24 h after surgery,the VAS scores when resting,moving and massaging the uterus were compared among three groups.The adverse reactions of three groups were compared.Results 4 h,8 h,12 h and 24 h after surgery,no significant difference was found among three groups in the VAS scores when resting,moving and massaging the uterus(P>0.05),but all the three groups had high VAS scores when massaging the uterus.The frequency of patient-controlled pressing in group C was significantly higher than that in group A(P<0.05).No respiratory depression or excessive sedation occurred in the three groups,and no significant difference was found among three groups in the incidences of nausea,vomiting and dizziness(P>0.05);The incidence of skin pruritus in group C was significantly lower than that in group A and group B(P<0.05).Conclusions 1 mg hydromorphone combined with ropivacaine applied in patient-controlled epidural analgesia after cesarean section has good effect and few adverse reactions,and is worthy of clinical application.

关 键 词：氢吗啡酮 剖宫产 硬膜外自控镇痛 不良反应 

分 类 号：R473.71[医药卫生—护理学]