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0 125 及0 2 罗比卡因与0 125 布比卡因用于分娩镇痛的比较 |
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孙茜芬 周齐鸣 曹蓉
摘要 目的：比较0.125％及0.2％罗比卡因与0.125％布比卡因在病人自控硬膜外镇痛（PCEA）分娩镇痛中应用的临床效果。方法：90例ASAⅠ～Ⅱ级足月初产妇，随机分为三组。A组采用0.125％罗比卡因（n＝30）；B组采用0.2％罗比卡因（n＝30）；C组采用0.125％布比卡因（n＝30）。三组均加入芬太尼2μg／ml。首剂负荷量给予10ml。采用电子镇痛泵调节持续量为5ml／h，单次按压量每次2ml，锁定时间15分钟。于宫口开至8～9cm时再给药10ml，宫口开全后停用麻醉药。结果：三组均能提供安全有效的分娩镇痛，产程时间无延长，阴道助产率无增加，剖宫产率显著下降，对胎儿、新生儿无不良影响。两组罗比卡因与布比卡因组比较，缩短产程时间明显，催产素使用率及阴道器械助产率无增加，对产妇下肢活动影响小。结论：与0.125％布比卡因相比0.125％或0.2％罗比卡因（均与2μg／ml芬太尼合用）在PCEA分娩镇痛中，感觉和运动阻滞明显分离，对分娩的影响更小，更适用于分娩镇痛。
关键词 罗比卡因 布比卡因 镇痛 硬膜外阻滞 分娩
A Comparison of Ropivacaine with Bupivacaine Used during Labor
Sun Qianfen，Zhou Qiming，Cao Rong
(Department of Anesthesiology，Chengdu 3rd Peoples Hospital 610031)
Abstract Objective：To compare the clinical effect of ropivacaine with bupivacaine used during labor．Methods：Ninty parturients were devided randomly three groups with 30 cases each．0.125％ or 0.2％ ropivacaine was given in group A or B respectively，and 0.125％ bupivacain in grop C．Fentanyl， 2μg／ml，was added in the local anesthetic solution for each group．A loading dose of 10ml was given，which was followed by continuous infusion of 5ml／h．PCA was set as follows：locked time 15min bolus dose 2ml．A bolus dose of 10ml was given when uterus oppening reached 8-9cm．The infusion stopped at full uterus opening．Results：Effective labor analgesia was provided in all three groups without prolongation of labor course，increase of instrumental labor or any adverse effect on the newbon．The labor process was shorter，use of oxytocin was less and effect on muscular tone on the low extremities was less in groups A and B than in group C．Conclusinon：Patient-controlled epidural analgesia with ropivacaine has less effect on the labor process conpared with bupivacaine．
Key words Ropivacain Bupivacaine Analgesia Epidural blockade Labor
近年来我院采用病人自控硬膜外镇痛术（PCEA）行分娩镇痛，将0.125％及0.2％罗比卡因与0.125％布比卡因应用于分娩镇痛并进行比较，现报告如下。
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