摘要
目的比较罗哌卡因腰麻硬膜外联合阻滞(CSEA)与布比卡因腰麻硬膜外联合阻滞行分娩镇痛的效果及对产程的影响。方法40例单胎足月初产妇随机分为两组,每组20例。两组均先在蛛网膜下腔分别注入罗哌卡因(Rop)2.5mg,加芬太尼20μg或布比卡因(Bup)2.5mg加芬太尼20μg后均留置硬膜外导管行硬膜外自控镇痛(PCEA),采用0.1%罗哌卡因或0.1%布比卡因,均与1.6μg·ml-1芬太尼混合液持续硬膜外输注5ml·h-1,自控镇痛3ml,锁定时间10min。结果两组镇痛效果良好,镇痛起效时间差异不显著(P>0.05),两组对产程、胎儿Apgar评分、阴道助产率、剖宫产率及催产素的使用率影响差异不显著(P>0.05)。但布比卡因组对运动神经的阻滞程度显著增高。结论低浓度罗哌卡因CSE+PCEA用于分娩镇痛,效果完善,比较低浓度布比卡因CSE+PCEA运动阻滞更轻微。
Objective To compare the efficacy of Ropivacaine with Bupivacaine used by combined spinal anesthesia and epidural anesthesia(CSEA) for labor pain. Method 40 cases of full term single embryony primipara were randomly allotted to two groups: Ropivacaine 2.5mg + Fentanyl 20μg were subarachnoidly injected in group Ⅰ(n=20), Bupivacaine 2.5mg + Fentanyl 20μg were subarachnoidly injected in group Ⅱ(n=20). The epidural catheter was placed for patient control epidural analgisia (PCEA): 0.1% Ropivacaine in group Ⅰ or 0.1% Bupivacaine in group Ⅱ with Fentanyl 1.6μg/ml were continuously given by epidural catheter 5ml/h,3ml for bolus, lockout time 10 min. Results The analgesic efficacy was all satisfactory in the two groups. There were no significant difference in two groups for the on set time of analgesia, the time of progress of labor, Apgars cores, rates of forceps delivery, and Cesarean delivery(P>0.05). The degree of motor never block was higher in group Ⅱ than that in group Ⅰ. Conclusion Low concentration of Ropivacaine used in CSE + CSEA for labor analgesia, effective, less motor never block compared with low contentration of Bupivacaine.
出处
《热带医学杂志》
CAS
2003年第3期357-358,371,共3页
Journal of Tropical Medicine
关键词
镇痛
分娩
罗哌卡因
布比卡因
芬太尼
analgesia
delivery
Ropivacaine
Bupivacaine
Fentanyl