剖宫产孕妇腰-硬联合麻醉后应用羟考酮和吗啡术后镇痛的效果及安全性对比

doi:10.3969/j.issn.10073205.2019.08.017

河北医科大学学报

剖宫产孕妇腰-硬联合麻醉后应用羟考酮和吗啡术后镇痛的效果及安全性对比

安徽省芜湖市第二人民医院麻醉科，安徽芜湖 241000

出版日期:2019-08-25 发布日期:2019-08-14
作者简介:彭基斌（1983-），男，安徽芜湖人，安徽省芜湖市第二人民医院主治医师，医学学士，从事临床麻醉学研究。

Comparison of effects and safety of oxycodone and morphine for postoperative analgesia after combined spinalepidural anesthesia for pregnant women undergoing cesarean section

Department of Anesthesiology, the Second People′s Hospital of Wuhu, Anhui Province, Wuhu 241000, China

Online:2019-08-25 Published:2019-08-14

摘要/Abstract

摘要： ［摘要］〓
〖HTH〗目的〖HTSS〗〖KG*2〗分析比较剖宫产孕妇腰-硬联合麻醉后应用羟考酮和吗啡术后镇痛的效果及安全性。
〖HTH〗方法〖HTSS〗〖KG*2〗回顾性分析我院68例行腰-硬联合麻醉剖宫产孕产妇临床资料，根据其术后镇痛方式分为羟考酮组36例及吗啡组32例。比较2组术后6 h（T1）、术后12 h（T2）、术后24 h（T3）、术后48 h（T4）视觉模拟评分法(Visual Analogue Scale，VAS)评分、血清皮质醇(cortisol，Cor)、血清泌乳素(prolactin，PRL)水平差异，并比较2组术后镇痛不良反应发生情况。
〖HTH〗结果〖HTSS〗〖KG*2〗2组术后各时点VAS评分和Cor水平均呈逐渐下降趋势，〖JP2〗但羟考酮组术后各时点VAS评分和Cor水平均低于吗啡组，2组PRL水平均呈先降低再升高，2组VAS评分、Cor水平和PRL水平在组间、时点间以及组间·〖JP〗时点间交互作用差异均有统计学意义（P＜005）。羟考酮组术后镇痛不良反应总发生率明显低于吗啡组（P＜005）。
〖HTH〗结论〖HTSS〗〖KG*2〗羟考酮在镇痛、控制不良反应方面更具有优势，对改善孕产妇术后泌乳功能也有积极意义。

关键词: 剖宫产术, 麻醉和镇痛, 羟考酮, 吗啡

Abstract: ［Abstract］ Objective〖HTSS〗〓To analyze and compare the effects and safety of oxycodone and morphine for postoperative analgesia after combined spinalepidural anesthesia for pregnant women undergoing cesarean section.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The clinical data of 68 cases of pregnant women with cesarean section who underwent combined spinalepidural anesthesia in our hospital were retrospectively analyzed. They were divided into oxycodone group(36 cases) and morphine group(32 cases) according to the postoperative analgesia methods. The Visual Analogue Scale(VAS) and levels of serum cortisol(Cor) and serum prolactin(PRL) were compared between the two groups at 6 h(T1), 12 h(T2), 24 h(T3) and 48 h(T4) after operation, and the occurrence of adverse reactions of postoperative analgesia was compared between the two groups.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The VAS score and Cor level in the two groups at different time points after operation showed gradual downward trend, and VAS score and Cor level in oxycodone group at different time points after operation were lower than those in morphine group(P＜005), and the PRL level was decreased first and then increased, and there were significant differences in the betweengroup effects, timepoint effects and interaction effects of betweengroups and timepoints of VAS score, Cor level and PRL level between the two groups(P＜005). The total incidence rate of adverse reactions of postoperative analgesia in oxycodone group was significantly lower than that in morphine group(P＜005).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Oxycodone has more advantages in analgesia and adverse reactions control, and it also has positive effects on improving postpartum lactation function.

Key words: cesarean section, anesthesia and analgesia, oxycodone, morphine

彭基斌，方明星，马〓娇，张〓骐. 剖宫产孕妇腰-硬联合麻醉后应用羟考酮和吗啡术后镇痛的效果及安全性对比[J]. 河北医科大学学报, doi: 10.3969/j.issn.10073205.2019.08.017.

PENG Jibin, FANG Mingxing, MA Jiao, ZHANG Qi. Comparison of effects and safety of oxycodone and morphine for postoperative analgesia after combined spinalepidural anesthesia for pregnant women undergoing cesarean section[J]. Journal of Hebei Medical University, doi: 10.3969/j.issn.10073205.2019.08.017.

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剖宫产孕妇腰-硬联合麻醉后应用羟考酮和吗啡术后镇痛的效果及安全性对比

Comparison of effects and safety of oxycodone and morphine for postoperative analgesia after combined spinalepidural anesthesia for pregnant women undergoing cesarean section

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