Efficacy of intrathecal morphine with epidural ropivacaine infusion for postcesarean analgesia
Efficacy of intrathecal morphine with epidural ropivacaine infusion for postcesarean analgesia
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DOI：
10.1016/j.jclinane.2009.09.003
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发表时间：
2010-06-01
影响因子：
6.7
通讯作者：
Iwasaki, Hiroshi
中科院分区：
文献类型：
--
作者：
Mikuni, Ikuomi;Hirai, Hiroyasu;Iwasaki, Hiroshi
研究目的：评价剖宫产术后镇痛和鞘内吗啡联合连续硬膜外输注时副作用的发生率。设计：随机、双盲研究。设置：大学医院。患者：76名阿萨身体状况I和II的足月产妇接受腰硬联合麻醉剖宫产。干预措施：患者被随机分为三组，分别接受0、50或100 μ g（第0组、第50组和第100组）鞘内吗啡和8 mg高压布比卡因。每例患者接受连续硬膜外输注0.2%罗哌卡因的速度为6毫升/小时。测量：24小时视觉模拟疼痛评分（VAPS），要求抢救镇痛药的患者人数，要求抢救镇痛药的频率，每例患者，并记录第一次要求抢救镇痛药的时间间隔。瘙痒和术后恶心呕吐（PONV）的频率也recorded.Main结果：组50和组100例患者表现出较低的VAPS和较长的时间间隔前的第一次请求救援镇痛药，他们要求救援镇痛药的频率低于0组患者。第100组的瘙痒频率显著高于第0组。组没有不同的PONV。结论：50 μ g和100 μ g的鞘内吗啡改善镇痛时，结合连续硬膜外输注的0.2%罗哌卡因（6毫升/小时）剖宫产后。鞘内注射50 μ g吗啡与低频率的副作用如瘙痒和PONV相关。(C)2010年爱思唯尔公司All rights reserved.
Study Objective: To evaluate the analgesia following cesarean delivery and the frequency of side effects of intrathecal morphine when combined with a continuous epidural infusion.Design: Randomized, double-blinded study.Setting: University hospital.Patients: 76 ASA physical status I and II term parturients undergoing cesarean delivery with combined spinal-epidural anesthesia.Interventions: Patients were randomized to one of three groups to receive 0, 50, or 100 mu g (Group 0, Group 50, and Group 100, respectively) intrathecal morphine in addition to 8 mg of hyperbaric bupivacaine. Each patient received a continuous epidural infusion of 0.2% ropivacaine at the rate of 6 mL/hr.Measurements: 24-hour visual analog pain scores (VAPS), number of patients who requested rescue analgesics, frequency of requests for rescue analgesics per patient, and time interval before the first request for rescue analgesics were recorded. Frequency of pruritus and postoperative nausea and vomiting (PONV) were also recorded.Main Results: Group 50 and Group 100 patients exhibited lower VAPS and longer time intervals before the first request for rescue analgesics, and they requested rescue analgesics less frequently than Group 0 patients. The frequency of pruritus was significantly higher in Group 100 than Group 0. The groups did not differ with regard to PONV.Conclusions: 50 mu g and 100 mu g of intrathecal morphine improve analgesia when combined with a continuous epidural infusion of 0.2% ropivacaine (6 mL/hr) after cesarean delivery. 50 mu g of intrathecal morphine is associated with a low frequency of side effects such as pruritus and PONV. (C) 2010 Elsevier Inc. All rights reserved.