摘要
目的 观察低浓度罗哌卡因联合小剂量芬太尼连续硬膜外阻滞在无痛分娩中的效果.方法 595例采用无痛分娩的产妇为观察组,595例自然分娩产妇为对照组,对照组未给予任何镇痛处理.观察组采用罗哌卡因80 mg与芬太尼0.2 mg溶于0.9％氯化钠注射液36 mL中,用自控镇痛泵泵入硬膜外腔,泵入速率5～8 mL/h,待宫口开全后关闭镇痛泵,期待自然分娩.结果 （1）观察组产妇第一产程较对照组明显缩短,差异有统计学意义（P＜0.01）,2组第二、三产程比较,差异均无统计学意义（P＞0.05）; （2）观察组产后出血量明显少于对照组,差异有统计学意义（P＜0.01）; （3）观察组疼痛程度多在0级及1级,对照组在2级及3级最多（P＜0.01）; （4）2组新生儿出生后1 min、5 min及10 min Apgar评分对比,差异均无统计学意义（P＞0.05）; （5）2组产妇心率（HR）、收缩压（SBP）、舒张压（DBP）及平均压（MAP）在第一产程潜伏期末对比差异无统计学意义（P＞0.05）;分娩后两组产妇HR、SBP、DBP及MAP对比差异均有统计学意义（P＜0.01）.结论 低浓度罗哌卡因联合小剂量芬太尼用于产妇分娩镇痛,起效迅速、效果确切、安全,可缩短第一产程,不影响第二、三产程及新生儿,产妇满意度高,是无痛分娩的一种理想麻醉方法,值得临床大力推广.
Objective To observe the effects of low concentration of ropivacaine combined with small dose of fentanyl for epidural anesthesia in painless labor effect.Methods 595 puerperas with painless childbirth were selected as the observation group,595 cases of spontaneous delivery were selected as the control group,the control group was not given any analgesic treatment.The observation group was treated with ropivacaine 80 mg and fentanyl 0.2 mg dissolved in 0.9％ sodium chloride injection 36 ml,with analgesia pump into the epidural cavity,pumping rate of 5 ～ 8 ml/h,analgesia pump was turned off to expect natural childbirth when the cervix dilated fully.Results （1） The first stage of puerperas in the observation group was significantly shorter than the control group,the difference was statistically significant （P＜0.01）,there were no significant differences in the second and three stage between two groups （P＞0.05） （2） Postpartum hemorrhage in the observation group was significantly less than the control group,the difference was statistically significant （P＜0.01） （3） The degree of pain was grade 0 and grade 1 in the observation group,and grade 2 and a maximum of 3 in the control group （P＜0.01） ; （4） There were statistically significant differences in Apgar score 1 min,5 min and 10 min after birth between two groups （P＞ 0.05） （5） There was no statistically significant differences in the maternal heart rate （HR）,systolic blood pressure （SBP）,diastolic blood pressure （DBP） and mean pressure （MAP） in the first stage of latent period between two groups （P＞0.05）.There were statistically significant differences in maternal HR,SBP,DBP and MAP after birth between two groups （P＜0.01） Conclusion Low concentrations of ropivacaine combined with small dose of fentanyl for labor analgesia has such advantages as rapid onset of action,efficacy,safety,shortening the first stage of labor without effect on the second,the three birth process and newborn,high maternal satisfaction,is an ideal anesthesia method for painless childbirth,and deserves the clinical promotion.
出处
《昆明医科大学学报》
CAS
2014年第12期148-151,共4页
Journal of Kunming Medical University
关键词
罗哌卡因
芬太尼
硬膜外阻滞
无痛分娩
Ropivacaine
Fentanyl
Epidural anesthesia
Painless childbirth
