DICLOFENAC SODIUM AND LOW DOSE EPIDURAL MORPHINE FOR POSTCESAREAN ANALGESIA

肌注Diclofenav Sodium合併低劑量硬脊膜外嗎啡用於剖腹產術後止痛

孫孝倫(Hsiao-Lun Sun)；鄭國偉(Kwo-Wai Cheng)；簡志誠(Chili-Cheng Chien)；車成君(Chcmg-Jiun Che)；張清鋒(Ching-Feng Chang)

Morphine ； diclofanc ； Epidural anesthesia ； Obstetic anesthesia

Acta Anaesthesiologica Sinica

28卷3期（1990 / 09 / 01）

295 - 301

英文

A ransomized double-blind study of parturients after Cesarean section was undetaken to assess the efficacy of the comination of single dose intramuscular diclofenac sodium and low dose epidural morphine (EM) for postoperative analgesia. 50 parturients under epidural anesthesia were divided into 2 treatment groups: group A received 2 mg EM 30 min after the last dose of lidocaine and 3 ml normal saline i.m. at recovery room; group B received the same EM and 75 mg diclofenac i.m. postoperatively. Pain scores were compared at the 2nd, 4th, 8th, 12th, 18th, and 24th h. Results showed that group B was superior to group A in analgesic quality from the 8th h and thereafter (P ＜ 0.05) and 100% patients in group B were in the excellent to good analgesia categories at the 8th and 12th h record compared to 92% and 72% patients in group A respectively. Side effects were similar in both groups. The combination of NSAIDs with low dose EM could improve the analgesic quality after Cesarean section.

本文為評估單一劑量肌注Diclofenac Sodium與硬脊膜外低劑量嗎啡合併使用，對剖腹產止痛敦效果。50位正常產婦以硬脊膜外麻醉接受剖腹產手術，在最後一次追加Lidocaine後30分鐘，經硬脊膜外導管給予2 ml嗎啡溶於10 ml生理鹽水之注射，產婦在被送達恢復室時分為A，B兩組，A組接受3ml生理鹽水，B組接受75 mg Diclofenac sodium（3 ml）深部臀肌注射，第2、4、8、12、18和24小時的疼痛分數均被同一麻醉醫師記錄比較。結果顯示，在第8小時後B組止痛效果優於A組（p＜0.005），在第8和第12小時A組產婦各有92%和72%及B組所有產婦的疼痛分數小於3分，兩組的副作用沒有差異，合併使用Diclofenac Sodium與硬脊膜外嗎啡可增進剖腹產術後止痛效果。