Wang J J, Ho S T, Liu H S, Tzeng J I, Tze T S, Liaw W J
Department of Anesthesiology, National Defense Medical Center/Tri-Service General Hospital, Taipei, Taiwan, R.O.C.
Acta Anaesthesiol Sin. 1995 Dec;33(4):211-6.
The treatment of post-cesarean section (C/S) pain is very important. Since no previous report discussed the preemptive effect of regional anesthesia on post-C/S pain, the present study was undertaken to evaluate the efficacy of the preemptive effect of regional anesthesia on post-C/S pain.
Ninety parturients scheduled for C/S were enrolled into one of the three groups (n = 30, per each group). The parturients in group 1 and 2 received spinal anesthesia and epidural anesthesia, respectively, while those in group 3 received general anesthesia for C/S. Postoperative patient-controlled analgesia, by means of intravenous morphine, was used for all paturients to relieve post-C/S pain. The VAS of pain and total morphine consumption were evaluated in all 3 groups of patients.
The results showed that groups 1 and 2 consumed less morphine than that of group 3. Also, there was no difference between groups 1 and 2 in the amount of morphine consumed. The incidence of side effects was significantly higher in group 3 than in groups 1 and 2.
We demonstrated that spinal or epidural anesthesia reduced the need of parenteral morphine postoperatively when compared with general anesthesia. We suggest that the use of regional anesthesia may provide a better preemptive effect for post-C/S pain.
剖宫产术后疼痛的治疗非常重要。由于此前尚无报告讨论区域麻醉对剖宫产术后疼痛的超前镇痛效果，因此本研究旨在评估区域麻醉对剖宫产术后疼痛的超前镇痛效果。
90例计划行剖宫产的产妇被纳入三组之一（每组n = 30）。第1组和第2组产妇分别接受脊髓麻醉和硬膜外麻醉，而第3组产妇接受剖宫产全身麻醉。所有产妇均采用静脉注射吗啡进行术后患者自控镇痛以缓解剖宫产术后疼痛。对所有3组患者评估疼痛视觉模拟评分（VAS）和吗啡总消耗量。
结果显示，第1组和第2组的吗啡消耗量低于第3组。此外，第1组和第2组之间的吗啡消耗量没有差异。第3组的副作用发生率明显高于第1组和第2组。
我们证明，与全身麻醉相比，脊髓麻醉或硬膜外麻醉可减少术后胃肠外给予吗啡的需求。我们建议，区域麻醉的使用可能为剖宫产术后疼痛提供更好的超前镇痛效果。
