摘要
目的:观察不同浓度舒芬太尼在腰硬联合阻滞分娩镇痛的镇痛效果。方法:选择择期初产妇180例,随机分六组,每组30例,分别为对照S0组,实验组S0.1组、S0.2组、S0.3组、S0.4组、S0.5组。各组镇痛方法均采用蛛网膜下腔给药后硬膜外留管产妇自控镇痛。鞘内镇痛药物为5.0μg舒芬太尼,硬膜外维持为0.15%罗哌卡因分别合用0、0.1、0.2、0.3、0.4、0.5μg/ml浓度的舒芬太尼,鞘内给药后90min开启硬膜外维持药,以相同的参数(负荷剂量6ml,维持7ml/h,PCA 3ml,锁定时间15min)行分娩镇痛。观察各组产程(活跃期、第二产程、第三产程)时间,启泵后15、30、60、90、120min后VAS评分,新生儿Apagr评分,改良Bromage评分,副作用(瘙痒、低血压、胎心异常改变、恶心呕吐、呼吸抑制等)。结果:S0组、S0.1组在各时间点VAS、S0.2组在15min VAS均高于S0.5组(P<0.05);S0组在各时间点VAS均高于S0.4组(P<0.05),S0.1组在15min、30minVAS、S0.2组在15min均高于S0.4组(P<0.05)。各产程时间、出血量、新生儿Apgar评分各组间比较均基本相似(P>0.05)。双下肢改良Bromage评分各组间均为0～1分,差异无显著性(P<0.05)。最常见的副作用是瘙痒,其他如恶心呕吐、低血压、呼吸抑制各组均未观察到。S0.5组瘙痒发生率明显高于S0组(P<0.05)。结论:鞘内应用5.0μg舒芬太尼后,硬膜外0.15%罗哌卡因复合0.3～0.4μg/ml浓度的舒芬太尼分娩镇痛,镇痛效果较好且不良反应发生率低。
Objective： Effects of different concentrations of sufentanil in epidural analgesia in labor analgesia. Methods： 180 parturients pregnant for the first time, were enrolled and divided into 6 groups randomly, each of 30 cases, respec- tively for the control group So, the experimental group So. 1, group S0. 2, group S0. 5, group So. 4, group S0.5. Groups of an- algesia were adopted in the subarachnoid space after the administration of epidural catheter maternal analgesia. Intrath- ecal sufentanil analgesia drug for 5μg, Epidural ropivacaine maintained for 0. 15% respectively combined 0,0. 1,0. 2, 0.3,0. 4,0. 5μg/ml concentration of sufentanil, intrathecal administration of drugs in 90 minutes after opening the epi- dural maintain drug,with the same parameters （loading dose of 6ml, maintain 7ml/h, PCA 3ml, locking time 15 mi- nutes） labor analgesia.Observe labor （active period, the second stage of labor, the third stage of labor）time, open the pump after 15,30,60,90,120 minutes after the VAS score, the Apagr score of newborns, the modified Bromage sco- ring, side effects （pruritus, hypotension, fetal heart abnormalities, nausea and vomiting, respiratory depression and oth- er）. Results： In SO group, So. a group at each time point VAS, S0.2 in the 15 minutes VAS group were higher than that in So. s group （P〈0. 05）;The SO group at each time point VAS were higher than that in So. 4 group（P〈0. 05）, in group S0.1, 15 minutes, 30 minutes VAS, S0.2 in the 15 minutes group were higher than that in So. 4 group（P〈0. 05）. The labor time, bleeding volume, neonatal Apgar score among three groups were similar（P〉0. 05）. Pair of lower limbs improved Bromage score between the groups are 0- 1, There was no significant difference（P〈0. 05）. The most common side effects are pruritus, others such as nausea and vomiting, hypotension, respiratory depression was not observed in each group. Group S0.5 pruritus occurred rate was significantly higher than group S0 （P〈0. 05）. Conclusion. In
出处
《医学理论与实践》
2012年第12期1428-1430,共3页
The Journal of Medical Theory and Practice
关键词
舒芬太尼
腰硬联合阻滞
分娩镇痛
Sufentanil, Spinal-epidural anesthesia, Labor analgesia
