王晓芳 1薛立超 2庄萍 2段应磊 2裴若萌 2王晓鹏2
作者信息
- 1. 山西医科大学麻醉学院,山西太原 030001
- 2. 山西医科大学第三医院(山西白求恩医院山西医学科学院同济山西医院),山西太原 030032
- 折叠
摘要
Abstract
Objective To observe the analgesic effects and adverse reactions of different doses of intrathecal morphine combined with ropivacaine after cesarean section,and to explore the optimal dose of intrathecal morphine.Methods A total of 150 single-term parturients with ASA Ⅰ to Ⅱ grade who planned to undergo elective cesarean section under subarachnoid anesthesia from February 2022 to May 2022 were randomly divided into 5 groups according to random number table method.8 cases were excluded due to various reasons,and 142 cases were enrolled ultimately.The dose of 0,25,50,100 and 200 µg of morphine combined with 15 mg ropivacaine were injected intrathecally in the group A(control group,n=28),B(n=28),C(n=29),D(n=29)and E(n=28)respectively.The time of first analgesia was observed within 48 h after the operation,and adverse reactions were recorded during the operation and after the operation.Results There was significant difference in the time of first request for analgesia within 48 h after cesarean section among the group A,B,C,D and E(P＜0.001).Meanwhile,there was significant difference between the group D and A(P=0.002),and the group E and A(P＜0.001),but there was no significant difference between the group D and E(P=0.110).The incidence of itching,nausea and vomiting of group E was significantly higher than those of group A(P＜0.001).Furthermore,the incidence of itching,nausea and vomiting was also higher in group E than those in group D,and the difference was statistically significant(P=0.043,P=0.001).No severe respiratory depression was found in all patients.Urinary retention occurred in 1 case of group E,and there was no statistical difference between the group E and A(P=0.169).Spearman correlation analysis revealed that the incidence of itching,nausea and vomiting was related to the dose of intrathecal morphine(r=0.419,P＜0.001,r=0.297,P＜0.001).Conclusion Both dose of 100 μg and 200 µg intrathecal morphine can achieve effective analgesia after cesarean section,but the former has fewer adverse reactions for parturients,and is worthy of clinical promotion.关键词
吗啡/罗哌卡因/鞘内注射/最佳剂量/剖宫产术Key words
morphine/ropivacaine/intrathecal injection/optimal dose/cesarean section
