剖宫产术后鞘内注射吗啡所致瘙痒治疗中纳布啡的最佳剂量
Optimal dose of nalbuphine for treatment of intrathecal-morphine induced pruritus after caesarean section.
作者信息
Somrat C, Oranuch K, Ketchada U, Siriprapa S, Thipawan R
机构信息
Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
出版信息
J Obstet Gynaecol Res. 1999 Jun;25(3):209-13. doi: 10.1111/j.1447-0756.1999.tb01149.x.
OBJECTIVE
To search for the optimal dosage of nalbuphine relief of intrathecal-morphine induced pruritus after caesarean section.
METHODS
Ninety parturients who developed moderate to severe pruritus caused by intrathecal morphine after caesarean section were randomly allocated into 3 groups receiving 2, 3 and 4 mg of intravenous nalbuphine respectively. The improvement of pruritus and adverse effects of nalbuphine such as increasing pain scores, nausea, vomiting, sedation and respiratory depression were evaluated at 15 minutes after nalbuphine administration.
RESULTS
Percentage of successful treatment of pruritus with 2, 3 and 4 mg, nalbuphine were 86.7, 96.7 and 100, respectively (p = 0.12). There was no statistically significant difference in adverse effects. No evidence of respiratory depression was detected. However, there was significant increase in pain scores in group of 4 mg nalbuphine (p = 0.004).
CONCLUSIONS
Nalbuphine of 2 to 3 mg was considered to be adequate in treatment of intrathecal morphine induced pruritus after caesarean section without increasing pain scores or causing other side effects.
目的
探寻用于缓解剖宫产术后鞘内注射吗啡所致瘙痒的纳布啡最佳剂量。
方法
90例剖宫产术后因鞘内注射吗啡出现中度至重度瘙痒的产妇被随机分为3组，分别静脉注射2 mg、3 mg和4 mg纳布啡。在注射纳布啡15分钟后，评估瘙痒的改善情况以及纳布啡的不良反应，如疼痛评分增加、恶心、呕吐、镇静和呼吸抑制。
结果
2 mg、3 mg和4 mg纳布啡治疗瘙痒的成功率分别为86.7%、96.7%和100%（p = 0.12）。不良反应方面无统计学显著差异。未检测到呼吸抑制的证据。然而，4 mg纳布啡组的疼痛评分显著增加（p = 0.004）。
结论
2至3 mg纳布啡被认为足以治疗剖宫产术后鞘内注射吗啡所致的瘙痒，且不会增加疼痛评分或引起其他副作用。
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