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德克萨斯州IV级孕产妇护理中心低剂量鞘内注射吗啡对剖宫产术后阿片类药物用量的影响。

Effect of a lower dose of intrathecal morphine on postoperative opioid consumption following cesarean delivery at a Texas level IV maternal care center.

作者信息

Saad Shahbaz, Vacula Madeline, Stacey Joanna K, Hofkamp Michael P

机构信息

Texas A&M School of Medicine, Round Rock, Texas, USA.

Centenary College, Shreveport, Louisiana, USA.

出版信息

Proc (Bayl Univ Med Cent). 2024 Oct 22;38(1):1-4. doi: 10.1080/08998280.2024.2418692. eCollection 2025.

Abstract

BACKGROUND

We hypothesized that patients who received a lower dose of intrathecal morphine (ITM) would have higher postoperative opioid consumption following cesarean delivery.

METHODS

Patients who had cesarean deliveries from February 15, 2022, through February 14, 2024 at Baylor Scott & White Medical Center - Temple with single injection spinal or combined spinal epidural anesthesia who did not have labor epidural anesthesia were included. Morphine milligram equivalent (MME) opioid consumption in the first 24 postoperative hours was recorded along with patient demographic, physical, and clinical characteristics.

RESULTS

A total of 535 and 502 patients received 0.2 and 0.15 mg ITM, respectively. Patients who received 0.15 mg ITM had higher rates of depression, scheduled cesarean deliveries, and acetaminophen administration compared to patients who received 0.2 mg ITM. Patients who received 0.2 mg ITM and 0.15 mg ITM had median (interquartile range) 24-hour MME consumption of 10.0 mg (0-30.0 mg) and 10.0 mg (0-40.0 mg), respectively ( = 0.97).

DISCUSSION

MME consumption for 24 hours following cesarean delivery was similar between patients who received 0.2 and 0.15 mg ITM.

摘要

背景

我们假设剖宫产术后接受较低剂量鞘内吗啡(ITM)的患者术后阿片类药物消耗量会更高。

方法

纳入2022年2月15日至2024年2月14日在贝勒·斯科特与怀特医疗中心-坦普尔接受单次注射脊麻或腰麻-硬膜外联合麻醉且未进行分娩硬膜外麻醉的剖宫产患者。记录术后首24小时吗啡毫克当量(MME)阿片类药物消耗量以及患者的人口统计学、身体和临床特征。

结果

分别有535例和502例患者接受了0.2 mg和0.15 mg的ITM。与接受0.2 mg ITM的患者相比,接受0.15 mg ITM的患者抑郁发生率、择期剖宫产率和对乙酰氨基酚使用率更高。接受0.2 mg ITM和0.15 mg ITM的患者术后24小时MME消耗量中位数(四分位间距)分别为10.0 mg(0 - 30.0 mg)和10.0 mg(0 - 40.0 mg)(P = 0.97)。

讨论

接受0.2 mg和0.15 mg ITM的患者剖宫产术后24小时MME消耗量相似。

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