罗哌卡因感觉神经分离阻滞分娩镇痛的临床研究

Clinic Study on Separating Blockage of Sensory Nerve with Ropivacaine During Labor

目的探讨罗哌卡因于蛛网膜下腔阻滞感觉神经中痛觉神经纤维、保留触觉的可行性及有效剂量计量单位。方法选择ASAⅠ-Ⅱ级足月单胎初产妇60例,随机分成Ⅰ组、Ⅱ组、Ⅲ组,每组20例。宫口开3 cm时分别于蛛网膜下腔注入罗哌卡因Ⅰ组2 mg、Ⅱ组2.5 mg、Ⅲ组3 mg;容积均为2.5 ml。观察项目:起效时间、阻滞平面、维持时间、VAS评分、触觉评分、运动阻滞评分、产妇血压、心率、宫缩及胎心。结果Ⅱ、Ⅲ组镇痛效果及维持时间明显优于Ⅰ组(P<0.05);Ⅰ、Ⅱ组运动神经、触觉神经阻滞评分低,与Ⅲ组有显著性差异(P<0.05)。结论蛛网膜下腔注射罗哌卡因2.5mg能够产生感觉神经中痛觉、触觉神经分离阻滞,镇痛效果良好。

Objective To investigate the availability of the separating blockage ot sentry nerve with ropivacaine during labor. Methods Sixty cases of ASA Ⅰ-Ⅱ full term primiparae were randomly divided into 3 groups （ n = 20） ： group Ⅰ,Ⅱ and Ⅲ were administered respectively with Ropivacaine （2.5ml） 2mg,2.5mg and 3mg by subarachnoid space when the uterine orifice dilated to 3cm. The level and time of analgesia , levels of algaesthesis （VAS scores）, degree of tactile sensation, motor blockage, the blood pressure, heart rate, uterine contraction and fetal heart rate of parturients were recorded andcompared during the parturition. Results The level of algaesthesis and time of analgesia in group Ⅱ and Ⅲ were significant differences than that in group Ⅰ（P〈 0.05）; The degree of tactile sensation and motor blockage in group Ⅰ and Ⅱ were significantly lower than that in group Ⅲ（ P 〈 0.05）. Conclusions 2.5mg ropivacaine a ministered by subarachnoid is effective in .separating blockage of sensory nerve and analgesia with negligible side- effect during labor.