布比卡因用于分娩自控硬膜外镇痛的观察

A comparison of 0.125% and 0.0625% bupivacine with fentanyl via patient-controlled epidural analgesia for the labor pain

目的 探讨布比卡因复合芬太尼病人自控硬膜外镇痛 (PCEA)对分娩镇痛、产程的影响。方法 2 12例行PCEA的足月初产妇随机分成A组和B组 ,分别给予 0 12 5 %和 0 0 6 2 5 %布比卡因 ,复合芬太尼 ;并与未给予任何镇痛药的同等条件产妇 475例 (对照组 )比较。结果 镇痛组分娩镇痛效果确切 ,未发现血压下降等副作用 ;产程催产素使用率与对照组相比均显著增高 (P <0 0 1) ,活跃期A组显著高于B组 (P <0 0 5 ) ;产程时间、新生儿Apgar评分、产后出血量、剖宫产和阴道助产率比较差异均无显著性。 结论 布比卡因复合芬太尼的PCEA镇痛效果确切安全 ,但催产素使用率高 ,与局麻药浓度有关 。

Objective To study the effects of labor analgesia of bupivacine with fentanyl via patient-controlled epidural analgesia(PCEA).Methods 212 nullipara women were assigned randomlytoreceive0 125%(Group A) or 0 0625%(Group B)bupivacineplusfentanylviaPCEA,475 nullipara women who were not administered any analgesic in the same condition(controlled group)were compared.Results Labor analgesia is effictive in Group A and B,and side effects such as hypotension were not found The rate of oxytocin use of Group A and B significantly increase compared with controlled group( P <0 01),which of the active phase Group A significantly increase compared with Group B( P <0 05) We found no significantly differences in the duration of labor,apgar score of neonate,the volume of postpartum bleeding,operative vaginal and cesarean delivery rates.Conclusion The PCEA provide effective and safe labor analgesia,but it increases oxytocin use,which is related to the concentration of anesthetic The augmentation of monitor during labor analgesia via PCEA is needed.