0.125％罗哌卡因不同时间间隔硬膜外规律间断注射分娩镇痛的效果

Efficacy of epidural regular intermittent injection of 0.125% ropivacaine at different time intervals on labor analgesia

目的 探讨不同时间间隔硬膜外规律间断注射0.125％罗哌卡因在分娩镇痛的临床效果.方法 有分娩镇痛要求的初产妇60例,随机分为45 min组（A组）、60 min组（B组）和75 min组（C组）.分别规律间隔45、60、75 min注射0.125％罗哌卡因6 ml,均无背景持续输注剂量.记录VAS、爆发痛、罗哌卡因用量、阻滞平面及不良反应发生率.结果 与镇痛前相比,3组产妇在实施分娩镇痛后VAS均降低（P＜0.05）,但3组间VAS比较差异无统计学意义（P＞0.05）.与A组相比,B组和C组罗哌卡因用量减少（P＜0.05）,而B组与C组间比较差异无统计学意义（P＞0.05）；3组最高感觉阻滞平面＜T8例数差异无统计学意义,但爆发痛次数以C组产妇最多.结论 硬膜外规律以6 ml/45min、6 ml/60min和6 ml/75min间断输注0.125％罗哌卡因均可有效用于分娩镇痛,如按“全程无痛、最小药物用量”的原则,则6 ml/60 min较好.

Objective To evaluate the clinical efficacy of epidural regular intermittent injection of 0. 125% ropivacaine at different time intervals on labor analgesia. Methods Sixty primiparae who requested labor analgesia were randomly divided into three groups., group of 45 min（group A）, group of 60 rain（group B）and group of 75 rain（group C）. All primiparae received epidural regular intermit- tent injection with 6 ml of 0. 125% ropivacaine without background continuous infusion dose. The time interval bolus was 6 ml/45min, 6 ml/60 rain and 6 ml/75 min in group A, B, C respectively. VAS, breakthrough pain, the consumption of ropivacaine, the block level and the side-effects were recorded. Results VAS was lowered after labor analgesia than before in each group （P（0.05）, but no significant difference in VAS was found among the three groups（P^0.05）. There was no signifi- cant difference in the case＇s number of maximal block level （T8 （P〉0.05）, the number of break- through pain was more in group C, the consumption of ropivacaine was less in group B and C than that in group A（P〈0. 05）, the consumption of ropivacaine was similar between group B and group C（P〉0.05）. No differences were observed in the delivery process and mode of delivery among the three groups （P〉0.05）. Conclusion The methods of epidural regular intermittent injection of 0. 125% ropivacaine without sufentanil at different time intervals of 6 ml/45min, 6 ml/60min and 6 ml/75min are all effective in labor analgesia, but the interval of 60 min is better according to the principle of ＂no pain in the whole course and minimum dosage＂.