Kadieva V S, Boezaart A P
Department of Anaesthesia, University of the Witwatersrand, Johannesburg.
S Afr Med J. 1990 Nov 17;78(10):603-4.
Preservative-free morphine sulphate (0.5 mg in 0.5 ml normal saline) was injected intrathecally as the sole analgesic in 10 primiparous patients in the first stage of labour. Elective forceps were applied under pudendal block anaesthesia to assist the second stage of labour to prevent cephalad spread during bearing down, and so reduce the side-effects of morphine sulphate. All patients reported good analgesia during the first stage of labour. There was no loss of the bearing down reflex and, except for mild peri-oral itching in 6 patients, no side-effect attributable to intrathecal morphine was noted. No side-effects of morphine sulphate were observed in any of the infants delivered. It is concluded that intrathecal morphine sulphate combined with elective forceps delivery provides a satisfactory alternative to epidural anaesthesia in those patients whose cardiovascular status demands preservation of a normal or elevated systemic vascular resistance.
对10例初产妇在第一产程鞘内注射无防腐剂的硫酸吗啡（0.5毫克溶于0.5毫升生理盐水中）作为唯一的镇痛剂。在阴部神经阻滞麻醉下应用选择性产钳助产第二产程，以防止分娩时胎头向上扩散，从而减少硫酸吗啡的副作用。所有患者在第一产程均报告镇痛效果良好。未出现屏气反射消失的情况，除6例患者有轻度口周瘙痒外，未发现鞘内注射吗啡引起的副作用。所分娩的婴儿均未观察到硫酸吗啡的副作用。结论是，对于心血管状况需要维持正常或升高的体循环血管阻力的患者，鞘内注射硫酸吗啡联合选择性产钳分娩为硬膜外麻醉提供了令人满意的替代方案。
