摘要
目的探讨盐酸氢吗啡酮超前镇痛在剖宫产产妇中的镇痛效果及对新生儿的影响。方法选择2018年3月至2018年12月我院拟行剖宫产的200例产妇,根据产妇意愿,分为观察组和对照组,每组100例,两组常规行剖宫产及术后硬膜外自控镇痛。观察组给予盐酸氢吗啡酮超前镇痛,对照组给予盐酸吗啡注射液超前镇痛。采用视觉模拟评分法(visual analogue scale,VAS)对两组术后不同时间点疼痛程度进行评价比较,同时对炎症因子水平、应激反应、泌乳功能及新生儿12 h的神经功能进行评分。观察并记录两组不良反应发生情况。结果术后两组VAS评分均较前降低;术后同一时间点,观察组VAS评分均低于对照组,差异均有统计学意义(P<0.05)。术后两组血清肿瘤坏死因子(tumor necrosis factor,TNF)-α、白介素(interleukin,IL)-6水平均较术前升高;术后6 h起,两组TNF-α、IL-6水平逐渐降低;术后同一时间点,观察组血清TNF-α、IL-6均低于对照组,差异有统计学意义(P<0.05)。术后两组血清去甲肾上腺素(noradrenaline,NE)、肾上腺素(adrenaline,E)及皮质醇(cortisol,Cor)水平均较术前升高;术后6 h起,两组血清NE、E及Cor水平均逐渐降低;术后同一时间点,观察组血清NE、E及Cor水平均低于对照组,差异有统计学意义(P<0.05)。术后两组泌乳素(prolactin,PRL)水平均较术前升高;术后6 h起,两组血清PRL水平均逐渐升高;术后同一时间点,观察组血清PRL水平高于对照组,差异有统计学意义(P<0.05),观察组总不良反应发生率(5.00%)低于对照组(13.00%,P<0.05)。观察组和对照组新生儿神经行为评分比较差异无统计学意义(P>0.05)。结论盐酸氢吗啡酮超前镇痛在剖宫产产妇中应用效果良好,且未对新生儿产生较明显的不良影响,安全性较好,值得临床应用、推广。
Objective To investigate the effect of preemptive analgesia with hydromorphone hydrochloride in cesarean section and its effect on newborns.Methods From March 2018 to December 2018,200 puerperant women who planned to undergo cesarean section in our hospital and they were divided into observation group and control groupaccording to the maternal wish,100 cases in each group.Routine cesarean section and postoperative patient-controlled epidural analgesia were performed in the both groups.The observation group was given preemptive analgesia with hydromorphone hydrochloride and the control group was given preemptive analgesia with morphine hydrochloride injection.The postoperative analgesia,inflammatory response,stress response,lactation function,neurological score and adverse reactions were compared between the two groups at different time points.Results At the same time after operation,the visual analogue scale(VAS)score of the observation group was lower than that of the control group,the difference was statistically significant(P<0.05).After operation,the levels of tumor necrosis factor-α(TNF-α)and interleukin(IL)-6 in the two groups were higher than those before operation.After 6 hours,the levels of TNF-αand IL-6 in the two groups decreased gradually.At the same time point after operation,the levels of TNF-αand IL-6 in the observation group were lower than those in the control group(P<0.05).The serum noradrenaline(NE),adrenaline(E)and cortisol(Cor)of the two groups were higher than those before operation,and the serum NE,E and Cor of the two groups were lower than those of the control group at the same time after operation(P<0.05).After operation,the level prolactin(PRL)in the both groups was higher than that before operation;from 6 hours after operation,the serum PRL in the two groups increased gradually.At the same time point after operation,the serum PRL in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).The total adverse reaction rat
作者
赵薇
ZHAO Wei(Department of Anesthesiology,Zigong Fourth People's Hospital,Zigong 643000,Sichuan Province,China)
出处
《世界临床药物》
CAS
2020年第6期461-467,共7页
World Clinical Drug
基金
自贡市2018科技局自贡市重点科技计划项目(2018CZ15)。
关键词
剖宫产
盐酸氢吗啡酮
超前镇痛
炎症反应
应激反应
新生儿
cesarean section
hydromorphone hydrochloride
preemptive analgesia
inflammation
stress response
newborns
