罗比卡因复合芬太尼硬膜外分娩镇痛的临床观察

Clinic Observation of Ropivacaine Compound Fentanyl Effect at Epidural Labor Analgesic

目的 :探讨罗比卡因复合芬太尼硬膜外分娩镇痛效果 ,以便寻求一种临床镇痛的有效方法。方法 :4 0例ASAI-II级单胎足月产妇 ,随机分成两组。Ⅰ组 (对照组 ,n =2 0 ) ,Ⅱ组 (观察组n =2 0 )。Ⅱ组 :第一产程宫口开 2～ 3cm。LⅡ～Ⅲ 硬膜外穿刺置管 ,注入 0 .2 %罗比卡因 13mL ,1h后 ,镇痛泵每小时维持输注 0 .2 %罗比卡因 10mL复合芬太尼 2 0mg。I组 ,LⅡ～Ⅲ 硬膜外注射 1%利多卡因 13mL ,每小时追加 10mL。两组均宫口开全时停药。比较两组的镇痛效果 (VSA)运动神经组织程度 ,产程 ,宫缩 ,新生儿评分 ,以及不良反应。以统计学分析结果。结果 :第一、二产程中Ⅱ组较Ⅰ组 ,VSA明显降低 (P <0 . 0 1) ,有显著差异。Ⅱ组较Ⅰ组“Apgar”评分低 (P >0 . 0 5 ) ,无显著差异。Ⅱ组较Ⅰ组 ,剖腹产率低 (P <0 . 0 1)有显著差异。结论 :罗比卡因复合芬太尼应用分娩镇痛术 ,安全有效 ,临床满意率高 ,对母体胎儿副作用小。

Objective: The main purpose of this study is to assess the Ropivacaine compound fentanyl effect at epidural labour analgesic, and found out an effective method for clinical application. Method: 40 cases ASA I～II of 10th months single fetus of primipara, had been divided into two groups at random。Group I (compare, n=20), group II (Ropivacaine, n=20). Group II: While primipara uterus opens 2～3cm, inject 0.2%ropivacaine 13ml by L Ⅱ～Ⅲ epidural block。One hour after, keep intravenous dripping of 0.2% ropivacaine 10 ml compound fentanyl 20 mg. Group I: L Ⅱ～Ⅲ epidural inject 1% lidocaine 13ml,superadd 10ml every hour. Each group stop drugging when the uterus opens to the full extent. VSA, block extent of motor nerve, stage of labour , uterine contraction,Apgar score and the adverse reactions were compared between the two groups. Use statistics method to analyse the results. Results: Compare the group II to the group I, VSA is obviously declining(P<0.01),there is a significant difference. “Apgar” score was lower (P>0.05),there was no significant difference. Caesarean rate was lower(P<0.01),there was a significant difference. Conclusion: Ropivacaine compound fentanyl was more effective and much safer at Epidural labor analgesic, and shows higher clinical satisfaction and fewer side effects