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低浓度布比卡因复合芬太尼硬膜外分娩镇痛的临床观察 |
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黎尚荣 陈秉学 孙来保 黑子清
摘要 目的：观察硬膜外低浓度布比卡因复合芬太尼行分娩镇痛的临床效果。方法：50例产妇随机分为镇痛组（E组）和对照组（C组）。E组在宫口开至3～4cm时开始硬膜外注药，采用首量＋持续背景量＋PCA（LCP）模式。镇痛药为0.125％布比卡因（每毫升含2μg芬太尼）。宫口开至8～9cm时停药。C组按产科常规处理。结果：硬膜外镇痛对产妇的生命体征无明显影响。E组产妇疼痛感比C组显著良好（P＜0.01）。运动不受影响，但对宫缩的感觉部分缺失，助产率显著高于C组（P＜0.05）。结论：0.125％布比卡因复合芬太尼用于硬膜外分娩镇痛能取得良好的镇痛效果。
关键词 布比卡因 芬太尼 镇痛 硬膜外阻滞
A Clinical Observation of Epidural Low Concentration of Bupivacaine Combined with Fentanyl for Labor Pain Relief
Li Shangrong， Chen Bingxue，Sun Laibao
(Department of Anesthesia，First Affiliated Hospital，Sun Yat-Sen University of Medical，GuangZhou 510080)
Abstract Objective：To study the effects of low concentration of bupivacaine combined with fentanyl on pain relief，the movement of lower extramites，uterotonic sensory and delivery modes during epidural analgesia in labor．Methods：Twenty-five parturients were selected for epidural analgesia as analgesia group （E） and no analgesia as nature delivery group （C）．An epidural catheter was placed at L2-3．A loading dose of 0.125％ bupivacaine 8-10 ml with fentanyl 50μg was given when utero-cervical was opened about 3-4cm．4ml of 0.125％ bupivacaine and 8μg of fentanyl were infused continuously by pumping until 8-9cm of utero-cervical opening was reached．Pain status，lower extramites motion，sensory to uterotonic and delivery modes of partureints were mesured in both groups throughout the study．Results：Epidural labor analgesia had no any significant effect on vital signs of the parturients．Pain sensation during laboring was markedly lighter in group E than that in group C．The rate of instrumental labor was higher in group E than that in group C． Conclusion：Epidural low concentration of bupivacine for labor can provide an excellent analgesia without lower extramites motor block．
Key word Bupivacaine Fentanyl Analgesia Epidural blockade
理想的分娩镇痛方式应能有效消除产妇疼痛，对母婴无任何不利影响。本研究观察以低浓度布比卡因与芬太尼的混合液行硬膜外镇痛的临床效果，并与自然分娩方式进行比较。[1] [2] 下一页
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