Scientific Research
Effects of single injection of morphine into epidural space on efficacy and adverse reactions of patient controlled intravenous analgesia with oxycodone for women after cesarean section
Xiaoli Du, Xudong Hu, Xunfeng Zheng, Shuxuan Yang, Qinzheng Hong, Yabin Wu, Xiaoxia Liang, Cheng Lin
Published 2019-05-01
Cite as IMHGN, 2019, 25(9): 1406-1410. DOI: 10.3760/cma.j.issn.1007-1245.2019.09.015
Abstract
ObjectiveTo study the effects of single injection of morphine into epidural space on the efficacy adverse reactions of patient controlled intravenous analgesia with oxycodone for wemen after cesarean section.
Methods80 ASA grade ⅠorⅡ parturients undergoing cesarean delivery were randomly divided into group A and group B, 40 cases for each group. 1.5 mg morphine (diluted with 5 ml saline) was injected into epidural cavity after the fetus was take out in group B, while the amount of saline was injected in group A. In both groups, epidura-spinal anesthesia was used and 3 mg oxycodone was administered intavenously after the cord clamped. Patient controlled intravenous analgesia with oxycodone was used for postoperative analgesia, and 27 mg oxycodone diluted with saline 100 ml for analgesic solution. The postoperative abdominal incision pain was evaluated using visual analogue scale (VAS) assessment at different time-points. The uterine contractions pain was evaluated using degree method 1 day and 2 days after operation. The adverse reactions were recorded. The analgesia satisfaction was adjudged by parturients. The level of serum prolactin (PRL) was determined with Chemiluminescence method using 2 ml venous blood sample 24 h after cesarean section.
ResultsThe VAS scores of incision 6 and 12 h after operation were significantly lower in group B than in group A (P<0.05); while there were no statistical differences in the VAS scores 2, 24, and 48 h after operation between the two groups (P>0.05). The degree of uterine contraction pain was significantly lower in group B than in group A (P<0.05). There was no statistical difference in the incidence of adverse reactions between the two groups (P>0.05). The times of breastfeeding for neonates after cesarean section was significantly more in group B than in group A (P<0.05). The maternal blood level of prolactin one day after operation was significantly higher in group B than in group A (P<0.05). The overall satisfaction of parturients for analgesia was significantly higher in group B than in group A (P<0.05).
ConclusionThe single injection of morphine into epidural space combined with intravenous analgesia with oxycodone is more effective than the intravenous analgesia with oxycodone, and is a good choice for postoperative analgesia for parturients after cesarean section.
Key words:
Epidural; Morphine; Postoperative analgesia; Patient controlled intravenous analgesia; Oxycodone; Cesarean section; Breastfeeding; Prolactin
Contributor Information
Xiaoli Du
Department of Anesthesiology, Foshan Second People's Hospital, Foshan 528000, China
Xudong Hu
Department of Anesthesiology, Foshan Second People's Hospital, Foshan 528000, China
Xunfeng Zheng
Department of Gynecology and Obstetrics, Foshan Second People's Hospital, Foshan 528000, China
Shuxuan Yang
Department of Anesthesiology, Foshan Second People's Hospital, Foshan 528000, China
Qinzheng Hong
Department of Anesthesiology, Foshan Second People's Hospital, Foshan 528000, China
Yabin Wu
Department of Anesthesiology, Foshan Second People's Hospital, Foshan 528000, China
Xiaoxia Liang
Department of Anesthesiology, Foshan Second People's Hospital, Foshan 528000, China
Cheng Lin
Department of Anesthesiology, Foshan Second People's Hospital, Foshan 528000, China
