摘要
目的 :探讨分娩镇痛的最佳方法及药物剂量。方法 :选择拟行自然分娩的单胎足月初产妇 180例随机分为 6组 ,宫口开至 3～ 4 cm时 ,A组硬膜外腔注入 0 .2 5 %布比卡因 8～ 12 ml。其它组均经蛛网膜下腔注入药物 ,其中 B组芬太尼 2 .5 μg+布比卡因 2 .5 mg共 2 ml;C、D组芬太尼 2 5 μg或 2 0 μg(1ml) ;E组芬太尼 2 5 μg (1ml) ,后经导管向硬膜外腔注入氟哌利多2 .5 mg;F组 0 .75 %罗比卡因 0 .5 ml(3.75 mg) +5 %葡萄糖液 1.5 ml。当其镇痛作用消失时 ,开始由硬膜外导管微量泵持续滴注药物 ,B、C、D、E4组均为 0 .0 95 %布比卡因与含芬太尼 2 μg/ ml的混合液 ,F组为 :0 .175 %罗比卡因。另设 30例作为对照组。观察的镇痛效果、阻滞情况、不良反应及对产程、母婴的影响。结果 :疼痛 0级的比率以 C、E、D组最高 ;A组镇痛起效时间最长 ,阻滞程度最重 ,阴道助产率最高 ;皮肤瘙痒率以 C、D组最高。结论 :E组镇痛效果最好 ,是一种母婴安全。
Objective:To explore the best method and medication dosage.Methods:180 primigravidas were randomly divided into 6 groups. When the external cervical os was dilated to 3~4cm, lumbar puncturing was performed at L2~3 or L3~4 with a special CSE needle . Group A: 0.25% bupivacaine 8~12 ml was injected into epidural space . Other groups were injected different medicament into subarachnoid space, then place the pipe in epidural space . Group B: fentanyl 2.5 μg plus bupivacaine 2.5 mg (total 2 ml); Group C and D: fentanyl 25 μg(1 ml)or 20 μg(1 ml); Group E: fentanyl 25 μg(1 ml), then 2.5 mg(2 ml) droperidol was injected into epidural space;Group F: 0.75% ropivacaine 0.5 ml(3.75 mg)was added to 5% glucose with a total volume of 1.5 ml . When subarachnoid block was wearing off,Above mentioned B,C,D and E group, the mixture that contained 0.095% bupivacaine+fentanyl 2 μg/ml was injected continuous into epidural space by patient controlled-epidural analgesia (PCEA).Group F , 0.175% ropi vacaine was started by PCEA.The infusion speed is 10 ml/h. When the external cervical os was dilated to 10cm,the PCEA was stopped .To investigate the analgesic effect,block degree of sensory and motor nerve.The influence of side effect for birth time and mode,postpartum haemorrhage and the condition of the fetus and the newborn,et al. Then compare with control group without analgesia.Results:The time of analgesic onset in group A was significantly longer than that in other groups(P<0.01).The rate of o-degree analgesia in group C,E and D was higher than that in group A,B and F(P<0.01 or <0.05).The rate of side effect(mainly in allergic itching of skin) in group C and D was higher than that in other groups (P<0.01).As for the upper limit of sensory plane block group A was the highest(P<0.05).Also,the block degree of lower limbs motor nerve in group A was deeper than that in other groups(P<0.01).About birth mode, the aid-vaginal birth rate of group A was significantly higher than that in other groups(P<0.01 ).Conclusion:The effect of labor
出处
《中国妇幼保健》
CAS
2004年第6期31-33,共3页
Maternal and Child Health Care of China
