不同剂量罗哌卡因联合芬太尼在分娩镇痛中的应用效果评价

Efficiency evaluation of different doses of ropivacaine combined with fentanyl for labor analgesia

目的探讨不同剂量罗哌卡因联合芬太尼在分娩镇痛中的应用效果及安全性.方法选取120例正常单胎初产妇作为研究对象,采用随机数字表法分为低剂量组(0.10%罗哌卡因复合芬太尼)、中剂量组(0.15%罗哌卡因复合芬太尼)及高剂量组(0.20%罗哌卡因复合芬太尼),每组40例.比较3组产妇镇痛情况、产程、分娩方式、新生儿Apgar评分及不良反应.结果镇痛后60、120min及宫口开3~4cm、7~8cm时,中剂量组及高剂量组产妇疼痛视觉模拟评分(VAS评分)显著低于低剂量组(P<0.05).高剂量组有4例(13.33%)产妇镇痛后出现运动阻滞,其他2组镇痛期间未发生运动阻滞.中剂量组及高剂量组镇痛起效时间显著短于低剂量组(P<0.05).各组产妇产程时间、分娩方式及新生儿Apgar评分比较,差异均无统计学意义(P>0.05).低剂量组、中剂量组、高剂量组不良反应发生率分别为2.50%、5.00%、20.00%,差异有统计学意义(P<0.05).结论0.15%罗哌卡因复合芬太尼用于分娩镇痛中的效果最好,安全性较高.

Objective To explore the efficiency and safety of different doses of ropivacaine combined with fentanyl for labor analgesia. Methods A total of 120 normal single birth primiparas were selected and randomly divided into low dose group (0.10% ropivacaine combined with fentanyl), medium dose group (0.15% ropivacaine combined with fentanyl) and high dose group (0.20% ropivacaine combined with fentanyl), with 40 cases in each group. Maternal analgesia, labor process, mode of delivery, neonatal Apgar score and adverse reactions were compared among the three groups. Results At the time points of 60 min and 120 min after analgesia, cervix opening 3 to 4 cm and 7 to 8 cm, the scores of maternal visual analogue scale (VAS) in medium dose group and high dose group were significantly lower than those in low dose group ( P <0.05). In high dose group, there were 4 cases (13.33%) with motor block after analgesia, and there was no case with motor block during analgesia in the other two groups. The onset time of analgesia in medium dose group and high dose group was significantly shorter than that in low dose group ( P <0.05). There were no significant differences in time of labor stage, mode of delivery and neonatal Apgar score among the three groups ( P >0.05). The incidence rates of adverse reactions in low dose group, medium dose group and high dose group were 2.50%, 5.00% and 20.00% respectively, and there were significant differences among the three groups ( P <0.05). Conclusion The 0.15% ropivacaine combined with fentanyl has the best effect and higher safety in labor analgesia.