摘要
目的观察不同浓度罗哌卡因复合鞘内注射舒芬太尼用于分娩镇痛的临床效果。方法选择2018年7月至2020年4月于我院自然分娩的足月产妇100例,随机分为A、B、C、D 4组,每组25例。A组为0.075%罗哌卡因加0.3μg/kg舒芬太尼,B组为0.1%罗哌卡因加0.3μg/kg舒芬太尼,C组为0.125%罗哌卡因加0.3μg/kg舒芬太尼,D组为0.15%罗哌卡因加0.3μg/kg舒芬太尼。宫口开至2~3 cm,于L2~3或L3~4间隙行硬膜外穿刺,硬膜外穿刺成功后,用25 G腰穿针经硬膜外穿刺针行蛛网膜下腔穿刺,回抽脑脊液稀释含舒芬太尼5μg药液至2 ml,向头端置管3~4 cm,30 min后连接PCEA泵,每组产妇接镇痛泵行产妇自控镇痛,分别给予相应浓度的罗哌卡因和舒芬太尼的混合液,观察各组疼痛视觉模拟评分(VAS)评分、产程时间、Bromage评分、产后出血量,同时观察新生儿Apgar评分。结果4组产妇在给药后10 min、30 min、60 min、90 min的VAS评分较给药前明显降低(P<0.05),90 min C、D 2组明显低于A、B 2组(P<0.05)。A、B、C 3组产妇Bromage评分明显优于D组,差异有统计学意义(P<0.05)。各组产妇的第一、二产程时间及新生儿Apgar评分比较差异无统计学意义(P>0.05);出血量比较,B、C 2组与A、D 2组比较差异有统计学意义(P<0.05)。结论应用0.1%或0.125%罗哌卡因复合0.3μg/ml舒芬太尼行腰硬联合分娩镇痛是安全合适的。其具有起效快,镇痛效果好,下肢运动阻滞风险低,产后出血量少,并对母婴安全影响小,更适合用于分娩镇痛。
Objective To investigate the clinical efficacy of intrathecal sufentanil bolus in combination with ropivacaine of different concentrations for labor analgesia.Methods Included in this study were a total of 100 women who underwent full-term spontaneous delivery in our hospital between July 2018 and April 2020,randomized into groups A,B,C,and D(n=25 each).The group A was administered with 0.075%ropivacaine plus 0.3μg/kg sufentanil,group B with 0.1%ropivacaine plus 0.3μg/kg sufentanil,group C with 0.125%ropivacaine plus 0.3μg/kg sufentanil,and group D with 0.15%ropivacaine plus 0.3μg/kg sufentanil.When the cervical opening was dilated to 2-3 cm,epidural puncture in the L2/3 or L3/4 interspace was performed.After successful epidural puncture,subarachnoid puncture with a 25-gauge spinal needle was performed through the passage of epidural puncture needle.Then,cerebrospinal fluid was drawn for dilution of 5μg sufentanil to 2 ml.A catheter was advanced 3-4 cm cranially,and connected to a patient-controlled epidural analgesia(PCEA)pump loaded with a mixture of ropivacaine and sufentanil of pre-designed doses at 30 minutes later.The VAS score,labor time,Bromage score,postpartum blood loss,and neonatal Apgar score were record and compared among groups.Results The VAS scores at 10,30,60 and 90 minutes after drug administration were significantly lower than baseline in any of the four groups(P<0.05).The 90-min VAS scores were significantly lower in groups C and D compared with groups A and B(P<0.05).The Bromage score in groups A,B and C were significantly better than that in group D,with statistically significant difference(P<0.05).There were no statistically significant differences in the time of first-and second-stage labor,and neonatal Apgar score among groups(P>0.05).The blood loss in groups B and C significantly differ from that in groups A and D(P<0.05).Conclusion 0.1%or 0.125%ropivacaine plus 0.3μg/ml sufentanil is safe and feasible for combined spinal-epidural analgesia,showing fast action,satisfactory analgesi
作者
樊素雄
王彦
何君艺
张瑞林
Fan Suxiong;Wang Yan;He Junyi;Zhang Ruilin(Department of Anesthesiology,the Sixth Division Hospital of Xinjiang Production and Construction Corps,Wujiaqu831300,China;不详)
出处
《中国药物与临床》
CAS
2020年第19期3191-3194,共4页
Chinese Remedies & Clinics
关键词
不同浓度
罗哌卡因
舒芬太尼
注射
脊髓
镇痛
产科
Different concentrations
Ropivacaine
Sufentanil
Injection,spinal
Analgesia,obstetrical
