浅析羟考酮注射液用于剖宫产术后硬膜外镇痛的临床效果

浅析羟考酮注射液用于剖宫产术后硬膜外镇痛的临床效果

摘要：目的研究分析羟考酮注射液用于剖宫产术后硬膜外镇痛的安全性及有效性。方法此次研究的对象是选择我院2017年2～5月择期行剖宫产术的产妇60例，将其临床资料进行回顾性分析，ASA Ⅰ～Ⅱ级，常规L2～3间隙连续硬膜外

麻醉，术后硬膜外镇痛，随机分为两组：M组，关腹时经硬膜外导管注入负荷量0.04%吗啡5 mL，术后患者自控镇痛（PCEA）配方为吗啡4 mg+0.75%盐酸罗哌卡

因20 mL/100 mL；Q组手术结束前关腹时经硬膜外导管注入负荷量0.04%羟考酮

5 mL，PCEA配方为羟考酮4 mg+0.75%盐酸罗哌卡因20 mL/100 mL，两组均于手

术结束时接电子镇痛泵PCEA。两组电子镇痛泵参数设置为：背景剂量：2 mL/h，

追加剂量2 mL/次，锁定时间20 min，镇痛持续48 h。分别测定术后6 h、24 h、

48 h两组切口痛、宫缩痛、Ramsay评分，记录术后阿片类药物不良反应。结果 Q 组术后6 h宫缩痛评分（1.1±0.2）分明显低于M组（1.8±0.4）分（P<0.05）；Q

组术后24 h宫缩痛评分（1.3±0.2）分明显低于M组（2.0±0.4）分（P<0.05）；Q

组术后48 h宫缩痛评分为（0.9±0.2）分明显低于M组（1.5±0.3）分（P<0.05）。Q组术后48 h内瘙痒、恶心、呕吐发生率均明显低于M组（P<0.05）。结论羟

考酮用于剖宫产硬膜外术后镇痛安全有效、不良反应发生率较吗啡低。

关键词：吗啡；羟考酮；剖宫产术；硬膜外镇痛

Objective：To study and analyze the safety and efficacy of oxycodone injection in epidural analgesia after cesarean section.Methods the object of this study was to select 60 cases of parturients undergoing cesarean section in 2~5 months of 2017 in

our hospital.The clinical data were retrospectively analyzed，ASA I to grade II，

routine L2 ~ 3 space continuous epidural anesthesia and postoperative epidural analgesia，randomly divided into two groups：group M，the load of epidural catheter injection of 0.04% Morphine 5 mL，postoperative patient controlled analgesia（PCEA）formula was morphine 4 mg+0.75% ropivacaine 20 mL/100 mL，Q group before the end of the operation through epidural catheter injection load of 0.04% HT 5 mL，PCEA formula 4 mg+0.75% hydrochloric hydrochloric 20 mL/100 mL，two groups at the end of the operation to connect the electronic analgesic pump PC EA.The parameters of the two groups of electronic analgesia pump were as follows：background dose：2 mL/h，additional dose 2 mL/ times，locking time 20 min，and analgesia lasted 48 h.Postoperative pain，uterine pain and Ramsay score were recorded in two groups 6 h，24 h and 48 h after operation respectively，and adverse effects of opioids were recorded.Results the score of 6 h uterine contraction pain（1.1 + 0.2）after operation in group Q was significantly lower than that in group M（1.8 + 0.4）（P<0.05），and 24 h score of uterine contraction pain（1.3 + 0.2）after operation in Q group was significantly lower than that of group M（2 + 0.4）

（P<0.05），and the score of 48 h contraction pain（0.9 + 0.2）after operation in group Q was significantly lower than that of M group（P<0.05）.The incidence of pruritus，nausea and vomiting in group Q after 48 h was significantly lower than that

in group M（P<0.05）.Conclusion oxycodone is safe and effective for epidural analgesia after cesarean section，and the incidence of adverse reactions is lower than that of morphine.

Keywords：morphine；oxycodone；cesarean section；epidural analgesia