低浓度罗哌卡因和左旋布比卡因在分娩镇痛中的效果观察

Effect Comparison of Low Concentration Ropivacaine and Levobupivacaine in Epidural Labor Analgesia

目的比较低浓度罗哌卡因和左旋布比卡因用于分娩镇痛的效果。方法40例初产妇随机分为0.1%罗哌卡因+2μg/ml芬太尼组和0.1%左旋布比卡因+2μg/ml芬太尼组。采用双盲法进行视觉模拟疼痛评分(VAS)和行走功能的评定。记录各组产妇的生命体征、胎心率(FHR)、产程时间、分娩方式、催产素用量以及新生儿Apgar评分。结果两组产妇分娩镇痛效果良好且无显著性差异(P>0.05)。镇痛后罗哌卡因组所有产妇均能下床行走和自主排尿,而左旋布比卡因组仅60%产妇能下床行走和自主排尿,两组比较有显著性差异(P<0.05)。结论低浓度罗派卡因用于无痛分娩优于左旋布比卡因。

Objective To compare the analgesic effect of ropivacaine with levobupivacaine at low concentration for labor alleviating pain. Methods Forty nulliparous full- term parturients were randomly assigned to two groups： group A （ n = 20） received 0.1% ropivacaine and 2μg/ml Fentanyl, while group B （ n = 20） received 0.1% levobupivacaine and 2μg/ml Fentanyl. The pain intensity was evaluated by the visual analog scale （VAS） according the prospective double- blind design. The adequacy of motor function for ambulation was assessed by using Modified Bromage Score （MBS）. The vital signs, fetal heart rate （FHR）, birth process, delivery mode and the volumes of oxytocin used were recorded, The neonate was assessed with Apgar＇s Score, Results Both group showed good effect on relief of labor pain, and there was no significant difference in VAS Scores （P 〉 0.05）. The percentage of no assisted walking and spontaneous micturation was 100% in the group A and only 60% in the group B. Conclusions Ropivacaine is more suitable than levobupivacaine at low concentration for epidural labor analgesia.