摘要
目的：观察罗哌卡因联合布托啡诺或芬太尼行硬膜外分娩镇痛的效果及不良反应。方法：选择60例初产妇接受L2-3硬膜外穿刺置管拟行分娩镇痛,按随机数字表法分为0.1%罗哌卡因联合16μg·ml^-1布托啡诺（B组）及0.1%罗哌卡因联合1μg·ml^-1芬太尼（F组）。监测镇痛过程中阻滞平面和运动阻滞（Bromage评分）、镇静镇痛评分及宫缩胎心;记录麻醉起效时间、产程时间、分娩方式、缩宫素使用增加例数以及新生儿Apgar评分。记录恶心、呕吐、瘙痒、胎心减速等不良反应的发生率。结果：两组产妇平均动脉压、心率、起效时间、产程时间、分娩方式及新生儿Apgar评分无显著差异;在不良反应观察上F组皮肤瘙痒、恶心呕吐的发生率明显高于B组,差异有统计学意义（P〈0.05）;B组有10例给药后15-30 min时镇静评分达到2分,明显高于芬太尼组,差异有统计学意义（P〈0.05）。两组间各时间点的VAS评分及运动神经阻滞发生的例数无显著差异。结论：布托啡诺16μg·ml^-1和芬太尼1μg·ml^-1联合0.10%罗哌卡因行于硬膜外分娩镇痛时镇痛效果相当,布托啡诺的不良反应更少,值得临床推广。
OBJECTIVE To observe effects and side effects of ropivacaine combined with butorphanol or fentanyl for epidural analgesia in labor.METHODS A total of 60 primiparae going to deliver under epidural analgesia by epidural intubation were selected and randomized into group B and group F.Patients in group B received 0.1%ropivacaine plus butorphanol 16μg·ml^-1,in group F received0.1%ropivacaine plus fentanyl 1μg·ml^-1.In the course of labor,block levels of epidural analgesia,Bromage scores,Ramsey scores,fetal heart rate-uterine contraction were monitored.In addition,onset time of anesthesia,labor time,number of case administering Oxytocind,Apgar scores of neonates were recorded.Occurrence rate of side effects were also calculated,including nausea,vomiting,pruritus and decreased fetal heart rate.RESULTS No significant difference was observed in maternal haemodynamics,labor duration,mode of delivery,Apgar scores of neonates,incidence of motor nerve blockade and number of case administering oxytocin between two groups.The incidences of pruritus and nausea/vomiting were higher in Group F than Group B（P0.05）.In group B,10 patients had a Bromage score2 15-30 min after medication,which was evidently different from Group F（P0.05）.CONCLUSION Combination of 0.10%ropivacaine with butorphanol 16μg·ml^-1 or fentanyl 1μg·ml^-1 has good analgesic effects for epidural analgesia in labor.Butorphanol has less side effects,and it is worthy of clinical promotion.
出处
《中国医院药学杂志》
CAS
CSCD
北大核心
2015年第3期240-244,共5页
Chinese Journal of Hospital Pharmacy
基金
浙江省医药卫生科技项目(编号:2012KYB130)
浙江省舟山市科技局项目(编号:2013C31067)
