论文部分内容阅读
目的 评价比较罗哌卡因与布卡因复合芬太尼硬膜外阻滞用于分娩镇痛的效果。方法 随机选择 10 0例足月单胎头位初产妇分别予罗哌卡因加芬太尼 (A组 ,n =5 0 )和布比卡因加芬太尼 (B组 ,n =5 0 )用于硬膜外阻滞镇痛分娩 ,并与自然分娩未镇痛 (C组 )相比较 ,观察各组产妇生命体征、视觉模拟评分 (VAS)感觉平面、运动阻滞程度分级、剖宫产率、新生儿Apgar评分情况。 结果 A、B两组镇痛效果良好 ,起效时间、VAS评分、产程和剖宫产率差异均无显著性 ,但B组有 3 2 %的产妇有明显的运动阻滞 ,而A组仅为 8% (P <0 .0 1)。A、B两组与C组比较 ,第一产程均明显缩短(P <0 .0 5 ) ,剖宫产率、新生儿Apgar评分差异均无显著性。 结论 低浓度的罗哌卡因和布比卡因复合芬太尼行硬膜外分娩镇痛效果满意 ,对产妇及婴儿安全。相比而言 ,罗哌卡因较布比卡因对产妇的运动阻滞明显轻微 ,更适合用于分娩镇痛。
Objective To evaluate the effect of epidural anesthesia with bupivacaine and bupivacaine combined with fentanyl for labor analgesia. Methods One hundred and ten primiparous single-head primipara were randomly selected to receive ropivacaine plus fentanyl (group A, n = 50) and bupivacaine plus fentanyl (group B, n = 50) Epidural block analgesia for delivery, and with natural childbirth without analgesia (C group) compared to observe the group of maternal vital signs, visual analogue scale (VAS) sensory plane, degree of motor block, cesarean section Rate, neonatal Apgar score. Results The analgesic effect was good in groups A and B, and there was no significant difference in onset time, VAS score, labor process and cesarean section rate, but 32% of mothers in group B had significant motor block, while group A only Was 8% (P <0.01). Compared with group C, the first stage of labor was significantly shortened in group A and group B (P <0.05), but there was no significant difference in cesarean section rate and neonatal Apgar score. Conclusions The low analgesic effect of epidural labor with low concentration of ropivacaine and bupivacaine combined with fentanyl is satisfactory and safe for maternal and infant. In contrast, ropivacaine was significantly less obstructive to mothers than bupivacaine and more suitable for labor analgesia.