无痛分娩中罗哌卡因与左旋布比卡因的镇痛效果和安全性比较

Comparation of effects and safety of ropivacaine and levobupivacaine in labor analgesia.

目的探讨罗哌卡因和左旋布比卡因分别联合芬太尼用于分娩镇痛的疗效和安全性。方法选取足月阴道分娩产妇170例,分为罗哌组(61例)、左旋组(55例)及未予镇痛的对照组(54例),观察并记录各组镇痛效果及对产程和母婴的影响。结果罗哌组、左旋组均取得良好镇痛效果(P<0.05);罗哌组第一产程(496.6±196.5)min,总产程时间(552.8±184.2)min;左旋组第一产程(503.1±201.7)min,总产程时间(569.3±182.0)min。两组均长于对照组(373.1±159.2)min、(429.0±126.4)min(P<0.05);产后出血量罗哌组(270.5±62.6)ml、左旋组(259.3±73.1)ml均高于对照组(228.8±55.0)(P<0.05)。结论罗哌卡因和左旋布比卡因分别联合芬太尼用于分娩镇痛可取得良好的镇痛效果,但可延长产程时间及增加产后出血量,对新生儿结局无明显影响。

Objective To investigate the effect and safety of ropivacaine or levobupivacaine combined with fentanyl in labor analgesia. Methods A total of 170 women on vaginal delivery were randomly divided into the ropivacaine group （ n = 61 ） and lcvobupivacaine group （n = 55 ）, and control group （n = 54 ） without labor analgesia. Analgesic effect on the mother and newborns was observed and recorded. Results Good analgesic effects were obtained in the two analgesic groups. The first and full labor process in the ropivacainc group （496.6±196.5 min,552.8 ± 184.2 rain, respectively） and lcvobupivacaine group（503.1 ± 201.7 min and tire 569.3± 182.0 min, respectively）was significantly longer than that in control group（373.1 ± 159.2 rain and 429.0 _± 126.4 min, respectively）. The postpartum hemorrhage in the ropivacaine gourp （ 270.5 ± 62.6 nil ） and levobupivacaine group （ 259.3 ± 73.1 ml ） was significantly higher than that in control group （228.8 ~ 55.0） （ P 〈 0.05 ）. Conclusions Ropivacaine and levobupivacaine both have good effect on labor analgesia, and no adverse effect on newborns, but more attention should be paid to the delay of labor process and postpartum hemorrhage.