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目的观察微量吗啡Spinocath导管连续腰麻用于分娩镇痛的有效性和安全性。方法Spinocath导管连续蛛网膜下腔镇痛组(Ⅰ组)与对照组(Ⅱ组)各15例初产妇,Ⅰ组于宫口开至2～3 cm时,注入吗啡0.1 mg。于第二产程开始时注入吗啡0.05mg+布比卡因1 mg,均在改平卧位后,调节痛觉上界平面为T_9。观察记录Ⅰ组产妇在给药后30min内呼吸循环变化及两组新生儿出生后Apgar评分、镇痛效果、运动神经阻滞、催产素的使用、产程进展、助产及剖宫产发生率、分娩镇痛的并发症;Ⅱ组为对照组,未做任何镇痛。结果与对照组比较,Spinocath导管连续蛛网膜下腔镇痛组对新生儿出生后Apgar评分、第三产程时间均无明显影响,第一产程、第二产程时间略有延长,但两组比较差异无统计学意义(P>0.05)。产痛显著减轻(P<0.05),对运动神经无影响(P>0.05),产后恶心、呕吐发生率增加(P<0.05)。结论微量吗啡Spino—cath导管连续腰麻用于分娩镇痛起效快,镇痛效果确切,对运动神经无阻滞,对新生儿及产程无明显影响,但其恶心呕吐发生率增加,且费用略显昂贵。
Objective To observe the efficacy and safety of morphine Spinocath continuous spinal anesthesia for labor analgesia. Methods 15 cases of primiparous women in group Ⅰ and group Ⅱ received Spinocath continuous arachnoid analgesia. Group Ⅰ received 0.1 mg of morphine when the cervix was opened to 2 ~ 3 cm. In the beginning of the second stage of injection of morphine 0.05mg + bupivacaine 1mg, were in the supine position, adjust the upper bound of pain threshold for the T_9. Observe and record the change of respiratory cycle in group I within 30 minutes and the Apgar score, analgesic effect, motor block, oxytocin use, labor course, midwifery and cesarean section rate, Labor complications of analgesia; Ⅱ group as the control group, did not make any analgesic. Results Compared with the control group, the Spinocath continuous arachnoid analgesia group had no significant effect on the Apgar score and the third stage of labor after birth, the first stage of labor and the second stage of labor slightly prolonged, but the difference between the two groups No statistical significance (P> 0.05). (P <0.05), no effect on motor nerves (P> 0.05), postpartum nausea and vomiting increased (P <0.05). Conclusion Spinal-microcirculation continuous spinal anesthesia with morphine for labor analgesia fast onset of onset, analgesic effect is exact, no block on the motor nerve, neonatal and labor no significant effect, but the incidence of nausea and vomiting increased, and costs Slightly expensive.