摘要
目的 了解氢吗啡酮用于剖宫产术硬膜外镇痛的临床效果和不良反应,为临床提供有效的麻醉方法.方法 116例剖宫产产妇按随机数字表法随机分为观察组65例和对照组51例,两组术后均采用硬膜外持续镇痛.其中观察组所用药物为氢吗啡酮＋罗哌卡因,对照组所用药物为吗啡＋罗哌卡因.评价两组的镇痛效果和镇静程度,并观察镇痛期间的药物不良反应,术后镇痛结束后调查满意度.结果 术后6、9、24 h时,观察组的VAS疼痛评分低于对照组,差异均有统计学意义（t=3.236、4.970、2.547,均P〈0.05）.术后3、6、9、24、48 h时,两组的Ramsay镇静评分的差异均无统计学意义（t=0.717、1.502、0.714、1.051、0.589,均P〉0.05）.两组术后首次排气时间的差异无统计学意义（t=0.730,P〉0.05）;观察组的镇痛满意度高于对照组,差异有统计学意义（t=2.301,P〈0.05）.观察组的不良反应发生率为7.69%,对照组为11.76%,差异无统计学意义（χ^2=0.552,P〉0.05）.结论 氢吗啡酮用于剖宫产术后硬膜外持续镇痛能有效地缓解产妇的术后疼痛,镇痛过程的安全性较高,具有良好的临床应用价值.
Objective To learn the clinical effect and adverse reaction of hydromorphone for continuous epidural analgesia after cesarean section,and to provide effective anesthesia method for clinical.Methods 116 cases of cesarean section were randomly divided into observation group（65 cases） and control group（51 cases）,continuous epidural analgesia was used in the two groups after operation.Among them,hydromorphone ＋ ropivacaine was used for the observation group,morphine ＋ ropivacaine was used for the control group.The analgesic effect and sedation degree of the two groups were evaluated.The adverse drug reactions were observed,and satisfaction of the patients after the operation was investigated.Results 6,9,24 hours after operation,the VAS pain scores of the observation group were lower than those of the control group,the differences were statistically significant（t=3.236,4.970,2.547,all P〈0.05）.3,6,9,24,48 hours after surgery, the differences of Ramsay sedation score between the two groups were not statistically significant（t=0.717,1.502,0.714,1.051,0.589,all P〉0.05）.The difference of postoperative first exhaust time between the two groups was not statistically significant（t=0.730,P〉0.05）.The satisfaction degree of the observation group was significantly higher than that of the control group,the difference was statistically significant（t=2.301,P〈0.05）.The incidence rate of adverse reactions of the observation group was 7.69%,which of the control group was 11.76%,the difference was not statistically significant（χ^2=0.552,P〉0.05）.Conclusion For continuous epidural analgesia after cesarean section,hydromorphone can effectively relieve the pain after operation,the safety of the process is high,and it has good clinical application value.
出处
《中国基层医药》
CAS
2017年第10期1571-1574,共4页
Chinese Journal of Primary Medicine and Pharmacy
关键词
剖宫产术
镇痛
硬膜外
氢吗啡酮
吗啡
罗哌卡因
Cesarean Section
Analgesia
Epidural
Hydromorphone
Morphine
Ropivacaine
