不同容量罗哌卡因用于剖宫产术后镇痛的比较

Comparison of Ropivacaine at Different Concentrations for Postoperative Analgesia in cesarean section

目的观察比较不同容量罗哌卡因用于剖宫产术后硬膜外镇痛效果及不良反应等的差异。方法选择在腰硬联合阻滞下行剖宫产产妇120例,随机分为A,B,C 3组,每组40例。硬膜外镇痛分别用0.08%、0.1%及0.125%罗哌卡因。所有产妇输注参数均为:负荷量5mg,持续泵入速度5mg/h,自控给药2.5mg/次。观察产妇在术后6h、12h、24h、36h和48h的动/静态VAS评分、PCA按压有效次数、Bromage评分和不良反应。结果随着硬膜外罗哌卡因给药容量的增加,在术后36h内,动/静态VAS评分、PCA按压效数、首次排气时间呈减少趋势(P<0.05),超过36h差异无统计学意义(P> 0.05)。结论 0.08%罗哌卡因组的镇痛效果和首次排气时间优于其它2组。

Obejectice To observe whether epidural analgesia with different volumes of ropivacaine used in cesarean section has differences in analgesic effect and adverse reactions.Methods 120 cases, ASA grade I-II grade,no contraindications for spinal anesthesia, voluntary Postoperative epidural analgesia is required. Randomly dividedinto A, B, C three groups. The concentration of group A, group B and group C were 0.08%, 0.10% and 0.125%respectively. All the postpartum patients were given loading dose of 5mg and the continuous infusion rate is 5mg/h, thebolus is 2.5mg/order. Patient-controlled interval was 20 min in all groups. The static VAS score, dynamic VAS score,Bromage score, the number of effective presses of PCA and adverse reactions in the four groups at 6h, 12h, 24h, 36h,48 hours were observed after cesarean section.Results Within 36 hours after operation, the dynamic VAS scores,static VAS scores, the number of effective presses of PCA and the first exhaust time in the A group were significantlylower than those in the C group（ 〈0.05）. There was no significant difference in all groups from the 36th to 48th hoursafter surgery（ 〉0.05）. During the whole observation period, there was no significant difference in dynamic VAS score,static VAS score, Bromage score, and exhaust time between group B and A and C.Conclusion After cesarean section, 5mg/h ropivacaine was administered for postoperative analgesia after epidural cesarean section, and the 0.08% group was superior to the 0.1% group and 0.125% group in terms of analgesic effect, intestinal exhalation time.