不同稀释容积芬太尼鞘内注射对分娩镇痛术中瘙痒的影响

Effects of diluted volumes of intrathecal fentanyl on pruritus during labour analgesia

目的:探讨不同稀释容积芬太尼鞘内注射对分娩镇痛术中瘙痒的影响。方法:100例分娩镇痛产妇随机分成4组,每组25例,均采用腰硬联合麻醉鞘内注入芬太尼20μg。4组稀释容积分别为1.5、2、2.5、3 ml。分别评估各组产妇瘙痒率、瘙痒程度以及疼痛视觉模拟评分(Visual analogue scale,VAS),并记录产妇感觉减退平面以及呼吸抑制、胎心减慢、恶心呕吐、低血压等不良反应。结果:3 ml组产妇瘙痒率和瘙痒程度低于1.5、2 ml 2组(P<0.05),较2.5 ml组有减轻趋势。4组产妇VAS评分及不良反应率差异无显著性(P>0.05)。结论:增加鞘内注射芬太尼的稀释容积可减轻分娩镇痛术中瘙痒。

Objective：To investigate the effects of diluted volumes of intrathecal fentanyl on pruritus during labour analgesia.Methods：One hundred parturients were randomly assigned to one of four groups to receive intrathecal fentanyl 20 μg in either 1.5,2,2.5 ml or 3 ml diluted volumes via a combined spinal-epidural technique（n=25 patients in each group）.The incidence and severity of pruritus and pain visual analogue scale（VAS）were assessed.The levels of reduced cold sensation and the occurrences of respiratory depression,fetal bradycardia,nausea,vomiting and hypotension were also recorded.Results：Compared with 1.5ml or 2 ml,3 ml diluted volume led to a decreased occurrence and severity of pruritus（P0.05）.No significant differences were found in VAS and the occurrences of side effects（P0.05）.Conclusion：Increasing diluted volumes of intrathecal fentanyl demonstrated a reduced incidence and severity of pruritus during labour analgesia.