摘要
目的观察右美托咪定或舒芬太尼联合罗哌卡因用于硬膜外分娩镇痛中的临床效果。方法 112例经阴道分娩足月初产妇实施硬膜外患者自控镇痛(PCA)。其中,56例(D组)采用右美托咪定2μg/ml+0.1%罗哌卡因100ml,另外56例(S组)采用舒芬太尼0.5μg/ml+0.1%罗哌卡因100ml。镇痛泵参数设定为:背景剂量8ml/h,PCA剂量每次5ml,锁定时间30min。比较两组分娩镇痛和镇静效果、第一和第二产程时间、改良Bromage评分和新生儿Apgar评分,检测脐动静脉血乳酸值,评估术后1、2d产妇焦虑自评量表(SAS)评分。观察镇痛相关不良反应发生情况。结果镇痛期间,D组VAS疼痛评分低于S组(P<0.05),Ramsay镇静评分高于S组(P<0.05)。产后1、2d,D组SAS评分均低于S组(P<0.05)。两组血压、产妇心率、胎心率、第一和第二产程时间、脐动脉血乳酸值、Apgar评分、改良Bromage评分无统计学差异(P>0.05)。两组均未出现明显药物不良反应。结论与舒芬太尼联合罗哌卡因产妇硬膜外PCA比较,右美托咪定联合罗哌卡因的镇痛和镇静效果更好。
Objective To observe the clinical efficacy of epidural labor analgesia with dexmedetomidine or sufentanil combined with ropivacaine.Methods The epidural labor analgesia with was performed in 112 full-term primiparas undergoing vaginal delivery,who were equally randomized into two groups.The analgesic solution consisted of 0.1% ropivacaine 100 ml containing dexmedetomidine 2μg/ml in group D or 0.1% ropivacaine 100 ml containing sufentanil 0.5μg/ml in group S.The analgesic variables of two groups were set up as a background infusion of 8 ml/h and a bolus dose of 5 ml in a lockout interval of 30 minutes.The outcomes of analgesia and sedation,the time of birth process,modified Bromage score and Apgar score were compared.The self-rating anxiety scale（SAS）score of the primiparas was evaluated on the 1^st and 2^nd day after delivery.The incidence of adverse responses was recorded as well.Results The VAS pain score during PCA was lower,while the Ramsay score was higher in group D than those in group S（P〈0.05）.The SAS score was lower in group D than that in group S on the 1^st and 2^nd day after delivery（P〈0.05）.There were no significant differences in BP,HR,fetal HR,first and second birth process,lactic acid value of umbilical arteriovenous blood,Apgar score and modified Bromage score between two groups（P〉0.05）.No significant adverse responses were found in two groups.Conclusion Compared to analgesia with ropivacaine and sufentanil,epidural labor analgesia with ropivacaine and dexmedetomidine provide more effective analgesia and sedation.
作者
朱晓昌
王艳
王宗
蔡慧茹
朱茜希
郭锡恩
ZHU Xiaochang;WANG Yan;WANG Zong(Department of Anesthesiology, Suqian Hospital of Traditional Chinese Medicine, Suqian 223800, CHIN)
出处
《江苏医药》
CAS
2018年第6期681-684,共4页
Jiangsu Medical Journal
