低浓度国产罗哌卡因行分娩镇痛的临床研究

An investigation on the analgesic effect of low-density ropivacaine(made in China) in child-bearing

目的观察不同浓度罗哌卡因配伍舒芬太尼用于分娩镇痛效果,探讨国产罗哌卡因最低有效浓度。方法自愿要求分娩镇痛产妇90例,ASAⅠ～Ⅱ级,头位,单胎,足月妊娠。随机分为3组:A组(n=30):0.1%国产罗哌卡因加舒芬太尼0.4μg/ml,B组(n=30):0.074%国产罗哌卡因加0.4μg/ml舒芬太尼,C组(n=30):0.1%盐酸罗哌卡因(耐乐品)加舒芬太尼0.4μg/ml。在第一产程活跃期施行分娩镇痛,记录产妇HR、BP、RR、SpO2;镇痛效果采用视觉模拟评分法(VAS)评估:0～10分,0分为完全无痛,10分为极度痛,<3分优、3～4分为良、5分为差、>5分为失败;运动神经阻滞采用改良Bromage评分,新生儿采用Apgar评分。结果3组产妇镇痛效果均满意,组间无差异(P>0.05)。结论0.074%罗哌卡因配伍0.4μg/ml舒芬太尼可安全有效用于分娩镇痛。

Objective To investigate the analgesic effect in childtbearing of ropivacaine of different density combined with sufentanil, and to observe the lowest effective denity of ropivacaine. Methods 90 cases of pregnant women desiring to prevent labor pain were selected.ASA. Ⅰ - Ⅱ grades,Head presentation,single-fetus, full-term gestation. They were divided into three groups randomly.A. （ n = 30） 0.1% ropivacaine ＋ sufentanil 0.4μg/ml; B. （ n = 30） 0.074 % ropivacaine ＋ 0.4/wo/ml sufentanil. C. （contrast） （ n = 30） 0.1% mpivacaine ＋ sufentanil 0.4μg/ml. Child-bearing anatgesia was carried out in the first active eouse of labor. The pregnant woment＇ s . HR, BP, RR, SpO2 were recorded. The analgesic effect was estimated by V. A.S. from 0 - 10.0. painless. 10. excruciation pain. 〈 3 excenellent effect,3-4 good effect,5 bad effect, 〉 5 failure. Estimation of motor nerves block was done by using improved Bromage method.The new-bom was estimated by Apagar method. Results These three groups got satisfactory analgesic results. No difference was observed between these three groups（ P 〉 0.01 ）. Conclusion Ropivacaine combined with snfentanil can be used safely and satisfactorily to prevent pain in child-bearing.