Mahdavi Atossa, Telkabadi Zeinab, Aleyasin Ashraf, Agha Hosseini Marzieh, Safdarian Leili, Momenzadeh Ali
Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Acta Med Iran. 2016 Nov;54(11):709-712.
This study investigated efficacy and side effects of Morphine suppository for pain management after the first elective caesarean delivery in comparison to Diclofenac suppository. One hundred women aged 18-40 with term pregnancies undergoing elective caesarean section for the first time participated in this prospective project. Exclusion criteria included drug sensitivity, fetal malformations or defects, and complications during the cesarean operation. After same spinal anesthesia and same surgical techniques and in the recovery room patients consecutively received 100 mg diclofenac suppository or 10 mg morphine suppository. The pain severity was rated by "Numerical Rating Scale." There was not the difference between two groups in terms of basal information. Pain score was significantly different between two groups in the first 12 hours (5.66 ±1.36 in morphine group and 3.63±0.96 in diclofenac group) but not in the second 12 hour period. Considering pain scores every two hours in first 12 hours and every 4 hours in second 12 hours, morphine group had higher scores in comparison to diclofenac group. Also, the morphine group required pethidine injection sooner than the other group. The time giving first pethidine injection was 3.28±2.16 hours after operation in morphine group and 5.24±4.07 hours after operation (P<0.05). This study demonstrated that diclofenac suppository in comparison to morphine suppository decreased subjective pain scores in the first twenty-four hours after elective caesarean section which reached statistical significance in the first twelve hours. Although in diclofenac group, pethidine injection was prescribed significantly later.
本研究调查了与双氯芬酸栓剂相比，吗啡栓剂用于首次择期剖宫产术后疼痛管理的疗效和副作用。100名年龄在18至40岁之间、首次因足月妊娠接受择期剖宫产的女性参与了这个前瞻性项目。排除标准包括药物过敏、胎儿畸形或缺陷以及剖宫产手术期间的并发症。在相同的脊髓麻醉和相同的手术技术下，患者在恢复室中依次接受100毫克双氯芬酸栓剂或10毫克吗啡栓剂。疼痛严重程度采用“数字评分量表”进行评定。两组在基础信息方面没有差异。两组在最初12小时内的疼痛评分有显著差异（吗啡组为5.66±1.36，双氯芬酸组为3.63±0.96），但在第二个12小时期间没有差异。考虑到在最初12小时内每两小时记录一次疼痛评分，在第二个12小时内每4小时记录一次疼痛评分，吗啡组的评分高于双氯芬酸组。此外，吗啡组比另一组更早需要注射哌替啶。吗啡组首次注射哌替啶的时间为术后3.28±2.16小时，另一组为术后5.24±4.07小时（P<0.05）。本研究表明，与吗啡栓剂相比，双氯芬酸栓剂在择期剖宫产后的头24小时内降低了主观疼痛评分，在最初12小时内达到统计学显著性。虽然在双氯芬酸组，哌替啶注射的处方时间明显更晚。
