摘要
目的评价不同浓度的罗哌卡因复合芬太尼行硬膜外分娩镇痛的临床效果,探讨较适宜的浓度。方法随机选择60例ASAI-Ⅱ级,头位,单胎,足月妊娠初产妇,分为三组,分别接受浓度为0.1%(A组),0.15%(B组),0.2%(C组)的罗哌卡因与2μg/ml芬太尼混合液,另选20例为对照组(D组)。镇痛组产妇硬膜外穿刺注入1%利多卡因5ml,5分钟后注入镇痛混合液7ml,30分钟后接镇痛泵,背景输注4ml/h,自控量2ml/次,锁定时间15min,至宫口开全时停用镇痛药,对照组按产科常规处理,观察产妇生命体征,评估镇痛效应及运动阻滞程度,观察记录产程进展,催产素使用情况,分娩方式及新生儿情况。结果不同浓度的镇痛药其镇痛效果无显著性差异。A组用药量最多,C组产妇感觉和运动有明显影响。结论0.15%罗哌卡因与2μg/ml芬太尼混合液用于硬膜外分娩镇痛效果良好,基本无运动及感觉阻滞,对产程及新生儿无明显影响,是合适的浓度。
Objective To evaluate a proper concentration of ropivacnine during patient -controlled epidual analgesia （ PCEA ） used for labor analgesia by comparing the effects of different concentration of ropivacaine and fantanyl. Methods 60 women in active labor were enrolled in this prospective, randomized study to receive ropivacaine 0.1%＋fentanyl 2μg/ml （group A）;ropivacaine 0.15%＋fentanyl 2μg/ml （group B）; ropivacaine 0.2%＋feutanyl 21-μg/ml（group C）and group D without PCEA as a eontrol.Epidural catheter was placed during active labor with 3cm cervical dilatation. The initial close was 5ml 1% Lidocaine and five minutes later 7ml of analgesic solution was administered and continuous pumping started at 30 win after that in group A,B and C. PCEA bolus close was 2ml with a 15 minutes lock out.All drμgs were stopped at the beginning of the second stage （10 cervical dilatation）. Pain relief was assessed by visual analogic pain scale （VAS） and motor block by modified Bromage .The uterotonie sensory , vital signs , labor process , mode of delivery , rate of Oxytocin required and effect on infants. Results There was no significant difference in group A,B and C.The total volume of medication of group A was highest. There was an obvious influence in motor and sensory in group C. Conclusions Ropivacaine 0.15%combined with fentanyl （2μg/ml）offers adequate analgesia without motor and sensory block and adverse effect on labor and infant and may be a suitable concentration for epidural labor analgesia.
出处
《海南医学》
CAS
2006年第5期33-34,共2页
Hainan Medical Journal
