摘要
目的 :观察病人自控低浓度罗哌卡因硬膜外阻滞在分娩中镇痛的效果及其对母婴、产程的影响。方法 :选择5 2例ASAⅠ -Ⅱ级、单胎头位足月妊娠的初产妇随机分为病人自控镇痛 (PCEA)组 (n =2 6 )和自然分娩对照组 (n =2 6 )。PCEA组在第一产程活跃期开始实施PCEA ,用药 0 .15 %罗哌卡因 +芬太尼 1μg ml,首次输注量 8～ 12ml ,PCEA基础注药速率为 5ml h ,冲击量为 2ml,锁定时间 15min。对PCEA组进行视觉模拟镇痛评分 (VAS)和下肢运动神经阻滞评分 (MBS) ;记录两组的产程时间、分娩方式和新生儿Apgar评分。结果 :两组产妇产程时间、分娩方式和新生儿Apgar评分比较无统计学差异 ;PCEA组用药后 15～ 30min均感到无痛或只感到轻度可耐受的疼痛 ,MBS镇痛前后比较无统计学差异 (P >0 .0 5 )。结论 :低浓度罗哌卡因PCEA行分娩镇痛效果确切 ,对运动神经阻滞轻 ,不影响产程及新生儿。
Objective: To observe the effects of low dose ropivacaine using patient controlled epidural analgesia on the labor course and both of parturients and infants.Methods:52 ASA parturients of physical statusⅠ-Ⅱ and with full term singleton fetus in the vertex presentation were divided into PCEA group(E, n =26) and control group(C, n =26),PCEA started at the beginning of the first labor process with 0.15% ropivacaine+fentanyl(1 μg/ml).The background dosage of 8～12 ml,Basic infusion 5 ml/h,bolus dosage:2 ml were administrated.Lockout time:15 min.The pain visual analogue scale(VAS) and degree of motor block on modified bromage score(MBS)were obtained before and after epidural block, the period of labor and the mode of delivery, and Apgar scores of neonate.Results:There was no significant difference in the labor course labor mode and Apgar score between two groups.The PCEA group had no pain nor mild pain after ropivacaine for labor analgesia. There was no significant diference in degree of motor block before and after labor analgesia.Conclusion:The low dose of ropivacaine for labor analgesia with PCEA is highly effective, less motor block and no effect on the duration of labor and neonate score.
出处
《江西医学院学报》
2003年第1期53-55,共3页
Acta Academiae Medicinae Jiangxi
