标题：剖腹产术后阿片类药物单次硬膜外镇痛对尿潴留的影响

      作者：王志华，陈 勇，欧阳碧山，梁 敏
    (海南省人民医院麻醉科，海南 海口 570311)

      卷次： 2012年23卷18期

      【摘要】 目的 比较剖腹产术后舒芬太尼、芬太尼及吗啡单次硬膜外镇痛对患者术后尿潴留的影响。
方法 90例ASAⅠ~Ⅱ级择期硬膜外麻醉下剖腹产患者随机分为三组(n=30)，夹闭胎儿脐带时，舒芬太尼组
(S组)硬膜外腔给予舒芬太尼 10 μg (5 ml)，芬太尼组(F组)给予 0.1 mg芬太尼(5 ml)；吗啡组(M组)给予 2 mg吗
啡(5 ml)。所有患者术后8 h拔除尿管。观察各组发生尿潴留例数，并记录各组患者的镇痛时间和术后并发症情
况。结果 M组有12例(40%)患者发生尿潴留，S组和F组分别为4例(13%)和3例(10%)。各组镇痛时间分别为
3 h (S组)、2 h (F组)和12 h (M组)。各组术后无一例患者发生呼吸抑制和神经并发症。结论 剖腹产术后硬膜
外单次注射吗啡比舒芬太尼和芬太尼更易产生尿潴留。

      【关键词】 舒芬太尼；硬膜外；镇痛；剖宫产

      【中图分类号】 R694+.55 【文献标识码】 A 【文章编号】 1003—6350（2012）18—068—02<

br>Effects of epidural opioids on postpartum urinary retention in women undergoing cesarean delivery.
WANG
Zhi-hua, CHEN Yong. OUYANG Bi-shan, LIANG Min. Department of Anesthesiology, People's Hospital of Hainan
Province, Haikou 570311, Hainan, CHINA

【Abstract】 Objective To determine the effects of epidural opioids regarding the incidence of postpartum uri-
nary retention (PUR) in women undergoing elective cesarean delivery. Methods 90 ASAⅠorⅡpatients undergoing
caesarean section (C/S) with epidural 2% lidocaine were randomized into three groups: Sufentanil group (S group),
Fentanyl group (F group) and Morphine group (M group). The patients in the three groups received 10 ug sufentanil
(S), 0.1 mg fentanyl (F) and 2 mg morphine (M) epidurally immediately after delivery, respectively. Bladder catheters
were removed 8 hours postpartum, and the incidence of postpartum urinary retention, and analgesic duration was re-
corded. Results Twelve (40%) patients in M group suffered PUR, while the incidence of PUR was significantly low-
er in group S (4 cases, 13%) and group F (3 cases, 10%). The analgesic duration for the three groups were 3 h, 2 h and
12 h, respectively. Conclusion The incidence of PUR was significantly lower with epidural sufentanil and fentanyl,
as compared with epidural morphine in women undergoing cesarean.

      【Key words】 Sufentanil; Epidural; Analgesia; Cesarean section
·临床经验·doi:10.3969/j.issn.1003-6350.2012.18.032