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目的研究不同剂量右美托咪定硬膜外给药辅助分娩镇痛的临床效果。方法选取2015年1月-2017年1月在丽水市妇幼保健院分娩的产妇120例,将产妇随机分成4组:每组30例。对照组1μg/kg芬太尼组(C组),0.5μg/kg右美托咪定组(D1组),1μg/kg右美托咪定组(D2组),2μg/kg右美托咪定组(D3组);记录产妇各产程持续时间、新生儿Apgar评分和使用缩宫素情况;在硬膜外开始起效后每15min记录VAS的镇痛评分;记录产妇分娩后的满意度和不良反应情况。结果镇痛后的15、30、45 min,4组产妇VAS评分比较差异均有统计学意义(均P<0.05),D1组产妇产程时间最短、药物用量最少,4组间比较差异均有统计学意义(均P<0.05)。4组产妇在Apagr评分方面比较差异均无统计学意义(均P>0.05)。D1、D2、D3组产妇满意均优于C组产妇(P<0.05)。C组产妇不良反应率高于其他3组(P<0.05)。结论右美托咪定0.5μg/kg联合罗哌卡因分娩镇痛效果优于芬太尼组。右美托咪定联合罗哌卡因既能够起到镇痛、镇静的效果,同时又在最大程度上降低了不良反应的出现。
Objective To study the clinical effects of different doses of dexmedetomidine epidural analgesia for assisted labor. Methods From January 2015 to January 2017,120 maternal births were given in Lishui MCH. The maternal women were randomly divided into 4 groups: 30 in each group. In the control group, 1μg / kg fentanyl group (C group), 0.5μg / kg dexmedetomidine group (D1 group), 1μg / kg dexmedetomidine group (D2 group), 2μg / kg dexmedetomidine Group D3 (group D3). The duration of labor, neonatal Apgar score and the use of oxytocin were recorded. The analgesic score of VAS was recorded every 15 minutes after the start of epidural. The satisfaction of childbirth and Adverse reactions. Results There were significant differences in VAS score between the four groups (all P <0.05) at 15, 30, 45 min after the analgesia, and the shortest labor duration and the lowest dosage of drugs in the D1 group were statistically significant Significance (both P <0.05). There was no significant difference in Apagr score between the 4 groups (all P> 0.05). The satisfaction of maternal in groups D1, D2 and D3 were better than those in group C (P <0.05). Adverse reactions in group C were higher than those in the other three groups (P <0.05). Conclusion Dexmedetomidine 0.5 μg / kg combined with ropivacaine is superior to fentanyl in labor analgesia. Dexmedetomidine combined with ropivacaine can both analgesic, sedative effect, while minimizing the emergence of adverse reactions.