剖宫产术毕前硬膜外导管内注射氢吗啡酮的镇痛效果观察  

Analgesic effect of epidural intradural injection of hydromorphone before the end of cesarean section

作　　者：李娟 李秀娜 杨红军 Li Juan;Li Xiuna;Yang Hongjun(Department of Anesthesiology and Perioperative Medicine,Jiaozuo Maternal and Child Health Hospital,Jiaozuo 454150,China;Department of Anesthesiology,the First Affiliated Hospital of Henan Polytechnic University,Jiaozuo 454150,China)

机构地区：[1]焦作市妇幼保健院麻醉与围术期医学科,焦作454150 [2]河南理工大学第一附属医院麻醉科,焦作454150

出　　处：《中国实用医刊》2024年第24期44-47,共4页Chinese Journal of Practical Medicine

摘　　要：目的观察剖宫产产妇术毕前硬膜外导管内注射氢吗啡酮的镇痛效果。方法队列研究。抽取2023年1月至2023年6月焦作市妇幼保健院收治的剖宫产产妇100例, 按随机数字表法分为对照组和研究组, 每组50例。对照组于术毕前硬膜外导管内注射吗啡镇痛, 研究组于术毕前硬膜外导管内注射氢吗啡酮镇痛。比较两组术后不同时间点视觉模拟评分法(VAS)评分、炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平、应激反应[皮质醇(Cor)、去甲肾上腺素(NE)]及不良反应发生率。结果术后6、12、24、48 h, 研究组VAS评分低于对照组(P<0.05)。术后12、24、48 h, 研究组IL-6和TNF-α、Cor和NE水平均低于对照组(P均<0.05)。研究组不良反应发生率(6.00%, 3/50)低于对照组(20.00%, 10/50), P<0.05。结论术毕前硬膜外导管内注射氢吗啡酮应用于剖宫产产妇中, 可缓解机体疼痛, 减轻术后炎症和应激反应, 且用药安全性较高。Objective To analyze the analgesic efficacy of epidural intradural injection of hydromorphone before the end of cesarean section.MethodsA total of 100 parturients who had cesarean section in Jiaozuo Maternal and Child Health Hospital from January 2023 to June 2023 were selected for the cohort study,and they were divided into the control group and the study group by random number table method,with 50 cases in each group.The control group was given epidural catheter injection of morphine for analgesia before the end of operation,and the study group was given epidural intradural injection of hydromorphone for analgesia before the end of operation.The visual analogue scale(VAS)score,the levels of inflammatory factors,including interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α),the stress response evaluated by cortisol(Cor)and norepinephrine(NE),were compared between the two groups at different time points after operation.And the incidences of adverse reactions were compared between the two groups.ResultsAt 6,12,24 and 48 h after operation,the VAS scores of the study group were lower than those of the control group(P<0.05).At 12,24 and 48 h after operation,the levels of IL-6,TNF-α,Cor and NE in the study group were lower than those in the control group(all P<0.05).The incidence of adverse reactions in the study group was 6.00%(3/50),lower than the 20.00%(10/50)in the control group(P<0.05).ConclusionsEpidural intradural injection of hydromorphone in cesarean section can relieve pain,relieve postoperative inflammation and stress response,with high safety.

关 键 词：剖宫产 氢吗啡酮 硬膜外导管给药 

分 类 号：R61[医药卫生—外科学]