硬膜外连续泵入罗比卡因与芬太尼用于30例分娩镇痛的临床观察

Clinical Observation of Continuous Epidural Infusion with Ropivacaine and Fent anyl to Relieve Pain of Labor

目的:观察罗比卡因复合芬太尼硬膜外分娩镇痛的临床效果。方法:美国麻醉医师协会分级法Ⅰ级60例产妇随机分为镇痛组和对照组。镇痛组在宫口开至2cm时,硬膜外穿刺接病人自控电子镇痛泵。镇痛药物为0.1%罗比卡因+芬太尼(1μg/ml)。注药速度为5ml/h,冲击量为2ml,锁定时间为10min。观察镇痛前后视觉模拟评分法(VAS)和改良Bromage评分,并记录产程时间、宫缩时间、宫缩间隔、催产素用量及新生儿Apgar评分。结果:硬膜外镇痛产妇生命体征平稳,镇痛后VAS评分明显降低(P<0.05),镇痛组第一产程缩短,对新生儿无不良影响。结论:罗比卡因复合芬太尼硬膜外分娩镇痛效果确切,对运动神经阻滞轻微,对新生儿无影响,是一较好的分娩镇痛方法。

Objective:To study the efficacy of epidural infusion with ropivaca ine combined with fentanyl on pain relief.Methods:Sixty parturients at labor we re randomly divided into analgesic group and control group.When cervix had opene d about 2 cm the patients of analgesic group were given continuous infusion of 0 .1%ropivacaine and fentanyl (1 μg/ml) on the speed of 5 ml every hour,at firs t 2 ml bolus,the total time of infusion was 10 min.The period of labor,the tim e of uterine contraction,the interval of uterine contraction,VAS,labor mode, amount of oxytocin and the Apgar score of neonatal were recorded at each labor p rocess.Results:There was no change of vital manifestation in analgesic group af ter epidural infusion. The scores of VAS wewe significantly lower than the contr ol(P< 0.05).There were no differences in neonatal Apgar scores between the two groups.The first stage of labour in analgesic group was shorter than the contol.Conclusion :Epidural infusion with ropivacaine and fentanyl is highly effective and the bl ock of motor never was slight.There was no influence of epidural infusion in the neonatals.The epidural infusion with ropivacaine and fentanyl is a good procedu re to relieve the pain of labour.