0.125%布比卡因复合芬太尼用于产妇自控硬膜外分娩镇痛的临床观察

Clinical investigation of patient-controlled epidureal analgesia with 0.125% Bupivacaine plus fentany in labour

目的评价布比卡因复合芬太尼用于产妇自控硬膜外镇痛的可行性。方法ASAⅠ～Ⅱ级初产妇,足月单胎108例随机分为2组,A组为观察组(病人自控镇痛)54例,应用0.125%布比卡因复合0.0025%芬太尼负荷量为12mL,当视觉模拟疼痛评分≥20mm时,自控给药3mL/h,锁定时间为15min,宫口开全停药,B组54例(不做硬膜外分娩镇痛)连续监测呼吸、循环状况,评估镇痛效应和运动阻滞的程度,观察记录产程进展,观察不良反应及新生儿情况。结果观察组给药5min后较给药前宫缩痛明显减轻(P<0.01),15min后宫缩痛基本消失。全产程镇痛优良率95%。新生儿评分、活跃期及第Ⅱ产程时间2组无显著差异。对照组剖宫产率显著高于观察组。结论0.125%布比尼因复合0.0025%芬太尼硬膜外自控镇痛安全有效。

[Objective] To investigate the feasibility of combining 0.125% Bupivacaine with Fentanyl in labour. [Methods] 108 cases of premiparas in spontaneous labour at full term were randomly assigned to two groups. Group A includes 54 cases. Epidural analgesia was maintained 12 mL 0.125% Bupivacaine plus 0.0025% Fentanyl. Losding does is 12 mL. When VAS 〉120 mm, drugs are infused on thu rate of 3 mL/h. Max infusing time is 15 min or ceased infusion with orifice fully opens. Group B includes 54 cases without patient-controlled epidural analgesia. Patients and newborns situations were observed. [Results] Pain from uterine contraction was released at 5 minutes and vanished at 15 minutes after the drugs were delivered in group A, （P〈0.01）. The pain conreol satisfaction during birth process is as high as 95%. There are no significant differences between Apgar criterion, time of active period and second stage of labor between group A and group B. The ratio of need cesarean section in group A is significant- ly lower than in group B. [Conclusion] It is safe and effective for patient-controlled epidural analgesia with 0.125% Bupivacaine plus Fentanyl in labour. The need of cesarean section can be decreased.