摘要
目的探讨不同浓度罗哌卡因联合不同剂量舒芬太尼在硬膜外自控分娩镇痛的效果观察。方法选择我院自2012年1月~2015年1月ASAI^II级镇痛分娩初产妇150例,随机分为三组,各50例,分别给予0.15%罗哌卡因联合舒芬太尼0.5μg/m L(R1组)、0.1%罗哌卡因联合舒芬太尼0.4μg/m L(R2组)、0.1%罗哌卡因联合舒芬太尼0.3μg/m L(R3组)。各组分别经硬膜外注入0.15%、0.125%、0.1%罗哌卡因分别复合舒芬太尼0.5、0.4、0.3μg/m L混合液5m L作为试验剂量,观察10min无全脊麻、广泛阻滞及局麻药中毒等不良反应后,再于硬膜外管给药10m L作为镇痛首次剂量,观察15min确定效果良好后连接患者自控镇痛泵,设置泵入速度5m L/h。比较观察三组患者的生命体征、镇痛效能、运动阻滞程度以及对产程、顺产率、产妇出血量和新生儿Apgar评分的影响,下肢麻木感、瘙痒、恶心、呕吐等不良反应发生率。结果三组在镇痛30min和分娩后,HR、MAP以及VAS评分、第一产程及第二产程时间、新生儿在各时间点Apgar评分未见统计学差异(P>0.05),但0.1%罗哌卡因联合0.3μg/m L舒芬太尼运动阻滞轻,下肢麻木感、瘙痒、恶心、呕吐等并发症发生率少,无痛分娩满意度评分高。结论 0.1%(极低浓度)罗哌卡因联合0.3μg/m L舒芬太尼在硬膜外自控分娩镇痛安全有效,运动阻滞少,不良反应少,具有良好的临床应用价值。
Objective To investigate the effect of different concentration ropivacaine with different doses of sufentanyl for patient-controlled epidural labor-analgesia.Methods 150 cases of primiparas （ASAⅠorⅡ） between 2012.1 and 2015.1 were randomly formed into three groups equally, group R1 （0.15% Ropivacaine with 0.5μg/mL Sufentanil）,group R2（0.125% Ropivacaine with 0.4μg/mL Sufentanil）,group R3（0.1% Ropivacaine with 0.3μg/mL Sufentanil）.All three groups started with 5mL of test dose,and followed with 10mL loading dose after 5-10 min’s observation,and continuous background infusion of 5mL/h ropivacaine （0.15%,0.125%,0.1%）with sufentanyl（0.5、0.4、0.3μg/mL）.Maternal vital signs,Visual Analogue Pain Scale （VAS） score,Modified Bromage Scale（MBS） of motion-block and neonatal Apgar scores,side-effects such as pruritus,nausea,vomiting were recorded. Results There were no significant differences between the three groups in HR,MAP,VAS score both 30min＇s labor-analgesia and after labor（P〉0.05）,nor in duration of the first and second labor-stage,Apgar score （P〉0.05）. The modified bromage scale（MBS） of motion-block was significantly lower in group R3（0.1% Ropivacaine with 0.3μg/mL Sufentanil（P〈0.05）.The incidence of itching,nause,vomiting were significantly lower and satisfactory score was significantly higher in group R3（P〈0.05）.Conclusion 0.1% Ropivacaine with low dose of Sufentanil for patients-controlled epidural labor-analgesia is effective in providing analgesia and reducing the side effects,and cause Less motion-block,and shows value for clinical application.
出处
《中国医药科学》
2015年第11期137-140,共4页
China Medicine And Pharmacy
关键词
罗哌卡因
舒芬太尼
硬膜外自控分娩镇痛
Ropivacaine
Low dose of Sufentanil
Patient-controlled epidural labor-analgesia
