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罗比卡因硬膜外分娩镇痛的临床研究 |
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姚尚龙 张小铭 陈鹏 武庆平
摘要 目的:研究低浓度罗比卡因病人自控硬膜外镇痛(PCEA)行分娩镇痛的效果。方法:选择109例ASAⅠ~Ⅱ级、头位、单胎足月妊娠的初产妇行PCEA(分娩镇痛组)。另选100例条件相仿但不给予硬膜外阻滞的自然分娩产妇为对照组。分娩镇痛组给予0.1%罗比卡因+芬太尼(1μg/ml),PCEA基础注药速率为6ml/h,冲击量为2ml,锁定时间为10分钟。进行视觉模拟镇痛评分(VAS)和下肢运动神经阻滞评分(MBS)。记录产程时间、生产方式。监测胎儿心率(FHR)、新生儿Apgar评分和SpO2。结果:分娩镇痛组用药后15~30分钟均感到无痛或只感到轻度可耐受的疼痛(VAS评分0.6±0.8)。分娩镇痛组产妇MBS在镇痛前后无统计学差异(P>0.05),所有产妇均能下床活动。分娩镇痛组产妇第一产程时间为464.9±173.5分钟,短于对照组第一产程时间(P<0.05)。分娩镇痛组第二产程时间为48.4±21.8分钟,对照组为46.7±20.6分钟,两组无统计学差异(P>0.05)。分娩镇痛组新生儿1、5分钟Apgar评分和SpO2与对照组无统计学差异(P>0.05)。结论:低浓度罗比卡因分娩镇痛效果确切,对运动神经阻滞轻,不影响产程及新生儿,是目前分娩镇痛较理想的方法。 关键词 罗比卡因 镇痛 硬膜外
A Clinical Study on Epidural Ropivacaine Labor Analgesia
Yao Shanglong,Zhang Xiaoming,Chen Peng (Department of Anesthesiology,Union Hospital of Tongji Medical University,Wuhan 430022)
Abstract Objective:To study the analgesic effects and motor block of low-dose ropivacaine using patient-controlled epidural analgesia (PCEA) in the parturients.Methods:109 ASA physical status Ⅰ or Ⅱ parturients full-term at received PCEA with 0.1% ropivacaine+fentanyl(1μg/ml).Basal infusion 6ml/h was supplemented with patient-controlled boluses (bolus dosage:2ml,lockout time:10min). The pain visual analogue scale(VAS) was obtained before and after epidural block.Degree of motor block on modified bromage score(MBS) was measured at the same time intervals.The duration of labor and mode of delivery were recorded.The fetal effect and the maternal uterine contractile activity were judged by continuous fetal heart rate(FHR)monitoring during labor.The neonate was assessed using Apgar scores. Results:109 parturients had no-pain or mild pain after ropivacaine for labor analgesia(VAS score 0.6±0.8).109 parturients had minimal motor bolck (scores of 0 or 1)in laboring.There was no difference in degree of motor block before and after labor analgesia(P>0.05).All parturients could freely walk out of bed in labor ana[1] [2] 下一页 上一个医学论文: 应用宫高 身高比值预测麻醉平面对剖宫产患者呼吸的影响 下一个医学论文: 分娩第一产程时布比卡因硬膜外镇痛最低有效浓度的研究
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