关键词: 吗啡, 鞘内注射, 超前镇痛, 术后镇痛

Abstract:

Objective To investigate the positive and adverse effects of intrathecal morphine injection on postoperative analgesia in caesarean sections.Methods Ninety ASA Ⅰ～Ⅱ patients for elective caesarean section were randomly divided into 3 groups with 30 cases for each.Before operation patients were injected intrathecal with ropivacaine 15 mg,NS 0.5 mL and 10% glucose 1 mL in group A and group C.Ropivacaine 15 mg,morphine 0.2 mg(0.5 mL) and 10% glucose 1 mL in group B.After operation,patients in group A and group B were given 0.16% ropivacaine and(0.002 5)% droperidol in the PCEA bump,total is 100 mL,The group C append 0.005%(5 mg) morphine.PCEA bump was intercalated: No load dosage+basal dosage 2 mL +(0.5) mL/per time+lock time 20 min.VAS and Prince-Henry methods were used postoperatively to evaluate pain feeling in 2,4,6,8,24,36 and 48 h.Results VAS and P-H value at each time in 24 h of group C were lower than group A,but there were no signficant differences(P>(0.05)) between group A and group C,which were higher than that in group B(P<0.01).The dose of PCEA and degrees of TPCA/EPCA in group A and group C were higher than that in group B(P<0.01). 10 and 9 cases needed other additional anaesthetics during postoperative 24 h in group A & C respectively,4 & 1 cases needed neostigmine to accelerate micturition and flatus in group C respectively.Side effects as nausea,vomiting,itching were more in group B than in group A and group C(P<0.05).Conclusion Intrathecal injection of morphine could not only provide satisfactory postoperative analgesia in caesarean sections but also reduce the dose of anesthetics,it had certain side effects yet.

Key words: morphine, intrathecal injection, preemptive analgesia, postoperative analgesia