Abboud T K, Shnider S M, Dailey P A, Raya J A, Sarkis F, Grobler N M, Sadri S, Khoo S S, DeSousa B, Baysinger C L
Br J Anaesth. 1984 Dec;56(12):1351-60. doi: 10.1093/bja/56.12.1351.
Thirty healthy women in active labour received an intrathecal injection of morphine 0.5 mg (n = 12) or 1 mg (n = 18) in 7.5% dextrose. Both doses provided excellent analgesia for labour, 93% of patients obtaining at least 50% pain relief. Analgesia began 15-60 min after injection and did not decrease until 6-8 h after injection. Analgesia was satisfactory until distension of the perineum, either by forceps or the infant's head. The intrathecal injection of morphine did not adversely affect the condition of the infant. Eighty per cent of patients developed pruritus; 53%, nausea or vomiting, or both; 43%, urinary retention; and 43%, drowsiness. These side effects were decreased by naloxone, which did not affect the degree of analgesia. There was no significant depression of ventilation in any patient. These results suggest that morphine 0.5 mg or 1 mg, administered intrathecally, effectively decreases the pain of labour, and that i.v. administration of naloxone can alleviate the common side effects.
30名处于分娩活跃期的健康女性接受了鞘内注射吗啡，其中12名注射0.5毫克吗啡，18名注射1毫克吗啡，均溶于7.5%葡萄糖溶液中。两种剂量的吗啡均为分娩提供了良好的镇痛效果，93%的患者疼痛缓解至少达50%。镇痛作用在注射后15 - 60分钟开始，直至注射后6 - 8小时才减弱。在使用产钳或胎儿头部导致会阴扩张之前，镇痛效果令人满意。鞘内注射吗啡对婴儿状况无不良影响。80%的患者出现瘙痒；53%出现恶心或呕吐，或两者皆有；43%出现尿潴留；43%出现嗜睡。纳洛酮可减轻这些副作用，且不影响镇痛程度。所有患者均未出现明显的通气抑制。这些结果表明，鞘内注射0.5毫克或1毫克吗啡可有效减轻分娩疼痛，静脉注射纳洛酮可缓解常见的副作用。
