Effects Of Intrathecal Morphine And Posto Perative PCIA With Sufentanyl For Postces Arean Analgesia On Women And Infants

ObjectiveTo investigate the effects of intrathecal morphine and patients-control intravenous analgesia (PCIA) with sufentanyl for postcesarean analgesia on women and infants.Methods30 ASA I-II normal pregnant women undergoing selective caesarean section were randomly classified into two groups: group A and B. The operation was performed under combined spinal-epidural anesthesia (CSEA) in L_2-3 spinal space. Group A(n=15) received 1% ropicaine 1.5ml and morphine 0.2mg intrathecally(IT) and group B(n=15) only received 1% ropicaine 1.5ml IT. And after operation the patients of group B received PCIA with sufentanyl 150μg added into NS 100ml, back ground infusion 2ml/h and keeping for 48 hours. These women were assessed for pain score(VAS 0-10), newborn behavior-neural assessment (NBNA), adverse effects of the morphine and sufentanyl and the immune changes.Results1 .Postoperative analgesia was satisfactory in both groups. From 24 to 48 hours after operations the VAS of group B was lower significantly than that of group A (p<0.05), but during the first 24 hours the VAS of both groups had no significant difference (p>0.05). 2. No significant differences of the NBNA in both groups were observed within different postoperative time (p>0.05). 3.The preoper- ative and postoperative concentrations of IL-2 and IL-6 between the two groups had no difference respectively(p>0.05,p>0.05). But in both groups the postoperative concentration of IL-6 increased significantly as compared with the preoperative concentration respectively (p<0.05). 4.The percentage of patients who had nausea,pruritus was higher in group A than in grop B(p<0.05). The gastrointestinal exhausting time and lactating time of both groups had no difference(p>0.05).ConclusionsPCIA with sufenanyl for postcesarean analgesia had higher satisfaction and no obvious side effects were observed on the patients' lactation and infant neural behavior.The intrathecal injection of morphine for postoperation is effective, can be administered in most hospitals,and is substantially less expensive.