Effects of single injection of morphine into epidural space on patient controlled intravenous analgesia with dezocine for parturient after cesarean section

Objective To observe the effects and the adverse reactions of single injection ofmorphine into epidural space on patient controlled intravenous analgesia with dezocine for parturient aftercesarean section.Methods Sixty patients with ASA grade Ⅰ or Ⅱ undergoing cesarean section wererandomly divided into control group and experimental group by random digits table and envelope method with30 cases each.The morphine 1.5 mg (diluted with 5 ml saline) was injected into epidural space after thefetus removed in experimental group while the amount of saline was injected in control group.In both groups,the combined epidura-spinal anesthesia was adopted and dezocine 5 mg was administrated intravenously afterthe fetus removed.The patient controlled intravenous analgesia with dezocine was used for postoperativeanalgesia and dezocine 25 mg diluted with saline 100 ml for analgesic solution with infusion rate of 2 ml/h.The analgesic effect was evaluated with visual analogue scale (VAS) and the adverse reactions were recorded.The times of breasffeeding for neonate during 48 h after cesarean section was recorded.The concentration of prolactin was determined with radioimmunity method through 2 ml venous blood sample before anesthesia and 24 h after cesarean section.Results The VAS score at 6,12 h after operation in experimental group was lower than that in control group [(2.3 ± 1.2) scores vs.(3.1 ± 1.0) scores,(2.5 ± 1.3)scores vs.(3.3 ± 1.5) scores],and there was significant difference (P ＜ 0.05),while there was no significant difference in the VAS score at 2,24,48 h after operation between two groups (P＞ 0.05).There was no significant difference in the incidence of adverse reactions such as nausea and vomiting,skin itching,dizziness,urinary retention,lower limb numbness,respiratory depression between two groups (P ＞ 0.05).The times of breastfeeding for neonate during 48 h after cesarean section in experimental group was higher than that in control group [(15.2 ± 5.5) times vs.(11.6 ± 6.8) times],and there was significant difference (P ＜ 0.05).There was no significant difference in the maternal blood concentration of prolactin at 24 h after operation between two groups (P ＞ 0.05).Conclusion The single injection of morphine into epidural space can enhance the analgesia effect of intravenous analgesia with dezocine,do not increase the adverse reaction and is benefit for the breasffeeding for neonate on parturient after cesarean section. Key words: Epidural space;  Morphine;  Analgesia,patient-controlled ;  Cesarean section; Dezocine