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罗哌卡因与布比卡因腰麻硬膜外联合阻滞行分娩镇痛的比较 被引量:2

Comparison of Ropivacaine with Bupivacaine Use in CSEA for Labor Analgesia
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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, Apgars 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
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同被引文献13

  • 1刘兴会,吴连方.分娩镇痛的临床应用与管理[J].中华妇产科杂志,2005,40(6):362-364. 被引量:90
  • 2黄宇光.新型长效局麻药在麻醉与神经阻滞中的研究进展[J].广东医学,2006,27(11):1602-1603. 被引量:10
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  • 7Camorcia M, Capogna G, Lyons G, et al. The relative motor blocking potencies of intrathecal ropivacaine: effects of concentration [J]. Anesth Analg, 2004,98 (8) : 1779-1782.
  • 8Malachy O, Columb MO, Lyons G. Determination of the minimum local analgesic concentrations of epidural bupivacaine and lidocaine in Labor [J]. Anesth Analg, 1995,81 (8) : 833-837.
  • 9黄新利,孙志超,张瑞坚,窦振波,高雷.神经刺激器引导下两点法颈丛加臂丛神经阻滞的效果观察[J].热带医学杂志,2013,13(2):221-223. 被引量:4
  • 10黎尚荣,陈秉学,孙来保,黑子清.低浓度布比卡因复合芬太尼硬膜外分娩镇痛的临床观察[J].临床麻醉学杂志,2000,16(11):551-553. 被引量:2

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