小剂量吗啡减轻经硬膜外分娩镇痛产妇产后宫缩痛的临床应用

Clinical Application of Low-Dose Morphine to Relieve Postpartum Uterine Contraction Pain of Puerpera Undergoing Epidural Labor Analgesia

摘要: 目的：观察小剂量吗啡经硬膜外注入对缓解产妇产后宫缩痛的效果。方法：选取本院产科已行硬膜外分娩镇痛的足月产妇(孕周 ≥ 38周) 60例，用计算机进行随机分组：吗啡组(M组)和对照组(C组)，单组样本设置为30。分娩镇痛产后观察0.5小时，产妇无特殊情况后，M组硬膜外推注吗啡2 mg，C组硬膜外推注盐水。产后0.5小时记录为T0，分别定T0时点后2小时、4小时、8小时、16小时、24小时为T1、T2、T3、T4、T5时点；记录下两组产妇各时点宫缩痛的VAS评分及恶心呕吐、皮肤瘙痒、尿潴留等副作用的发生率。结果：M组产妇产后宫缩痛的VAS评分在T1、T2、T3、T4、T5明显低于C组(P < 0.05)。恶心呕吐、皮肤瘙痒及尿潴留的发生率两组间不存在显著性差异(P > 0.05)。结论：小剂量吗啡硬膜外注射能缓解产妇的产后子宫收缩痛，而不会增加不良反应的发生率。

Abstract: Objective: To observe the effect of epidural injection of low-dose morphine on postpartum uterine contraction pain in maternal. Methods: Sixty cases of full-term maternal (gestational weeks ≥ 38 weeks) who had undergone epidural labor analgesia in the Obstetrics Department of our hospital were selected and randomized by the computer: morphine group (Group M) and control group (Group C), with 30 samples in each group. Labor analgesia was observed for 0.5 h after labor. After no special conditions, 2 mg of morphine was injected into Group M with epidural extrapolation, and epidural saline in Group C with epidural extrapolation. It is recorded as T0 half an hour after giving birth, and 2 hours, 4 hours, 8 hours, 16 hours together with 24 hours after T0 are respectively rec-orded as T1, T2, T3, T4 as well as T5 time points; the VAS scores of the two groups of women with uterine contraction at different time points were recorded, and the incidence of side effects such as nausea and vomiting, skin pruritus and urinary retention were recorded. Results: At T1, T2, T3, T4 and T5 time points, the VAS score of group M was significantly lower than that of group C (P < 0.05). There was no significant difference in incidence of nausea, vomiting, pruritus and urinary retention between the two groups (P > 0.05). Conclusion: Low-dose morphine epidural injection relieves postpartum uterine tenderness in maternal without increasing the incidence of adverse effects.