摘要:目的：观察0.125%左布比卡因联合吗啡地塞米松用于剖宫产术后持续硬膜外镇痛效果及对产妇恢复的影响。方法：选择60例健康足月产妇，在硬膜外麻醉下施行剖宫产术。术毕随机分为两组：硬膜外镇痛组(镇痛组)和对照组。镇痛组在硬膜外腔持续用0.125%布比卡因、吗啡5mg与地塞米松10mg混合液镇痛;对照组为病房常规杜冷丁100mg肌注组。观察：①在12h、24h、48h各时间点疼痛视觉模拟评分、宫底高度变化、运动阻滞程度、不良反应；②开始泌乳时间；③肠排气时间。结果：两组各时间点在疼痛评分上镇痛组优于对照组，两组相比差异有显著性(p<0.01)，在宫高、不良反应、运动阻滞评分比较差异无显著性。镇痛组的肠排气和初乳时间显著短于对照组(p<0.01)。结论：0.125%左布比卡因联合吗啡地塞米松用于持续硬膜外镇痛，安全有效、副作用小，对剖宫产术后产妇能产生良好的镇痛效果同时，可缩短初乳时间，有利于早期哺乳和产妇术后康复。

    关键词: 左布比卡因; 吗啡; 地塞米松; 术后镇痛; 产妇恢复

    The Effect of Postoperative Analgesia with Bupivacaine Combined with Morphine Dexamethasone on the recovery of parturient

    SHAN Ren-yong , YU Qing-he , CAO Zi-hua , et al

    ( Chang'an Hospital of Dongguan , Guangdong Dongguan 511700, China )

    Abstract :Objective : Observing the effect of postoperative analgesia after cesarean section with 0.125% bupivacaine combined with morphine and dexamethasone on the recovery of parturient . Method: 60 cases healthy parturient underwent cesarean section with epidural anesthesia. And they were divided into two groups: epidural analgesia group and control group. The analgesia group were injected continuously 0.125% bupivacaine and 5mg morphine and 10mg dexamethasone. The control group were given 100mg Dulengding . And then ,observe ① The graded of visual imitation, the changes of height of fundus of uterus . and the degree of block at 12h, 24h and 48h .②The time of lactation .③ The time of intestinal exhaust. Result : There s significant difference between analgesia group group and control group. The former is superior to the latter (p<0.01 ) . There's no significant difference in the height of fundus of uterus , bad action , graded of block . The time of first lactation and intestinal exhaust are both earlier than control group. Conclusion : It safe and with little side effect for the postoperative analgesia after cesarean section with 0.125% bupivacaine combined with morphine and dexamethasone. It can shortern the time of first lactation. And it's better for the breast feeding early and better for the recovery of parturient. ......