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目的 监测剖宫产术后硬膜外镇痛产妇血及初乳中的吗啡含量 ,探讨微量吗啡对新生儿的影响。 方法 选择剖宫产术的产妇 10 0例 ,分为实验组和对照组各 5 0例 ,两组均为连续硬膜外麻醉 ,穿刺点选择 L1 ～ L3,麻醉药为 2 %利多卡因 15～ 2 0 m l,在手术结束时 ,实验组将吗啡缓慢注入硬膜外管 2 mg然后拔管。于术后 1h取产妇的静脉血 3m l,采集产妇术后 3、6 h尿样及术毕 6～ 12 h采集新生儿尿样 3m l;在产后 4 8h内收集产妇的初乳 3～ 5 m l。 结果 观察组 96 % (48/ 5 0 )的镇痛效果较对照 16 % (8/ 5 0 )明显 ,差异有显著性 (P<0 .0 5 ) ,观察组血吗啡浓度 <5～ 118μg/ m l,初乳吗啡浓度 <5～ 30 .4μg/ L ,产妇尿 92 %呈阳性 ,新生儿尿 13.3%呈阳性。两组产妇和新生儿的生命体征比较差异无显著性。 结论 剖宫产术后硬膜外腔应用吗啡镇痛 ,产妇哺乳对新生儿没有影响 ,是安全可行的。
Objective To monitor the content of morphine in maternal blood and colostrum after epidural analgesia after cesarean section and to explore the effect of morphine on newborns. Methods A total of 100 maternal women undergoing cesarean section were selected and divided into experimental group and control group with 50 cases each. The two groups were continuous epidural anesthesia, with L1 ~ L3 puncture points and 2% lidocaine anesthesia 15 ~ 20 ml. At the end of the operation, the experimental group slowly injected morphine 2 mg into the epidural tube and extubated. 1h after surgery to take maternal venous blood 3ml, collecting 3,6 hours after maternal urine and urine samples 6 ~ 12 h after surgery to collect newborn urine samples 3ml; colostrum collected colostrum 3 ~ 5 ml. Results The analgesic effect of 96% (48/50) in the observation group was significantly higher than that of the control (16%) (8/50) (P <0.05) ml, colostrum morphine concentration <5 ~ 30 .4μg / L, maternal urine was 92% positive, neonate urine was 13.3% positive. There was no significant difference in the vital signs between the two groups of mothers and newborns. Conclusions Morphine analgesia is applied to the epidural space after cesarean section. Maternal lactation has no effect on the newborn and is safe and feasible.