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題名 | Reconsidering the Value of Intrathecal Morphine for Post-Cesarean Analgesia--A Rural Practice Experience=使用脊髓腔內嗎啡注射作剖腹產患者的術後止痛--偏遠地區的臨床經驗 |
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作者 | 蘇文祥; 王鵬惠; 吳博霖; 張昇平; 袁九重; | 書刊名 | 臺灣婦產科醫學會會刊雜誌 |
卷期 | 42:2 2003.06[民92.06] |
頁次 | 頁121-125 |
分類號 | 417.372 |
關鍵詞 | 剖腹產; 脊椎腔內注射嗎啡; 半身麻醉; Cesarean section; Intrathecal morphine; Spinal anesthesia; |
語文 | 英文(English) |
中文摘要 | 目的:在沒有足夠麻醉科人力及設備的偏遠醫院,使用脊髓半身麻醉時添加嗎啡作剖腹產患者之術後止痛。本研究將評估其止痛效果、副作用。材料和方法:在台東聖母醫院從1997年5月到1997年12月共收集了44個案例,其中研究組22個病人接受腰椎半身麻醉,注入marcaine時同時加入0.2mg嗎啡,而控制組則加入了0.2c..食鹽水,我們分析了兩組在術後24小時內所使用不同藥物的頻率,藉以比較兩組間的差異。結果:研究組使用Demerol止痛的頻率顯著降低(4.7% vs. 72.7%),使用NSAID 止痛的頻率也降低(14.3% vs. 86.4%):相反地,使用抗組織膠來止癢的頻率偏高(42.8% vs. 0%),P < 0.004,同時象徵護理工作負擔的額外注射,在研究組也較小(P=0.003)。結論:在偏遠地區沒有足夠的麻醉人力及設備作硬脊膜外術後止痛時,脊髓腔內注射嗎啡可安全而有效的給剖腹產患者術後止痛,減少止痛針劑的使用。 |
英文摘要 | Objective: The aim of this study was to assess the analgesic and side effects of intrathecal morphine in cases of elective cesarean section (C/S) in a hospital in rural Taiwan with a shortage of well-trained staff and adequate equipment. Material(s) and Method(s): A retrospective case-controlled study was done in 44 cases of elective C/S performed from May 1997 through December 1997 at the St. Mary’s Hospital in Taitung. The study group consisted of 22 patients who received an additional 0.2 mg morphine with intrathecal macaine anesthesia. The control group consisted of 22 patients who received routine spinal anesthesia with marcaine and 0.2 ml saline. All drugs used during hospitalization were analyzed. The frequencies of pethidine and/or non-steroid anti-inflammatory drug (NSAID) use for pain relief during the initial 24 hours after surgery were calculated to test the effects of intrathecal morphine. The drugs used to treat side effects were also compared between the two groups. Patient requests for any of the drugs mentioned above were calculated and evaluated according to burden on the nursing staff. Result(s): The age, parity, body weight, body height, incision wound, interval between the last C/S, and education level were similar in both groups. The frequencies of pethidine and/or NSAID use for pain relief after surgery were significantly reduced in the morphine group (4.7% versus 72.7%, P<0.01 and 14.3% versus 86.4%, P<0.01, respectively). In contrast, the incidence of anti-histamine drug use for pruritus relief was significantly increased (42.8% versus 0%, P<0.01) in the study group. The study group asked significantly less post-operative injections than the control group (P<0.01). Conclusion(s): In a rural practice with a shortage of manpower and facilities, intrathecal morphine might provide good analgesia during the initial 24 hours after elective C/S based on effectiveness and safety. However, unwanted side effects such as pruritus might interfere with routine recovery. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。