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目的:观察罗哌卡因椎管内阻滞用于分娩镇痛的临床疗效。方法:选择自愿接受减痛分娩的产妇3087例,均为足月初产、单胎头先露,均无宫缩乏力及妊娠并发症,分为罗哌卡因组(观察组)1550例和布比卡因组(对照组)1537例。于第一产程开始镇痛,常规取L2-3间隙行穿刺麻醉。观察组给予0.2%罗哌卡因+芬太尼2μg/ml,对照组给予0.125%布比卡因+芬太尼2μg/ml。比较两组镇痛效果,麻醉前后血压、心率变化,下肢运动神经阻滞发生率、各产程时间及机械助产率。结果:两组可靠镇痛率及各产程时间均差异不显著(P>0.05);两组血压、心率与镇痛前比较均差异不显著(P>0.05);观察组下肢运动神经阻滞发生率、需机械助产率均显著低于对照组(P<0.05)。结论:罗哌卡因椎管内阻滞用于分娩镇痛优于布比卡因。
Objective: To observe the clinical efficacy of ropivacaine spinal block for labor analgesia. Methods: A total of 3087 maternal women who received painless delivery of labor were selected. All of them were full-term primiparous, with only unborn fetus and no complications of pregnancy. They were divided into 1550 cases of ropivacaine (observation group) 1537 cases of caffeine (control group). In the first stage of labor began to relieve pain, routine take L2-3 gap line anesthesia. The observation group was given 0.2% ropivacaine + fentanyl 2μg / ml and the control group was given 0.125% bupivacaine + fentanyl 2μg / ml. The analgesic effect, blood pressure and heart rate before and after anesthesia, the incidence of lower extremity motor block, labor time and mechanical obstetric rate were compared between the two groups. Results: There was no significant difference between the two groups (P> 0.05). The blood pressure and heart rate of the two groups were not significantly different from those before the analgesia (P> 0.05). Motor nerve block Rate, required mechanical birth rate were significantly lower than the control group (P <0.05). Conclusion: Ropivacaine spinal block is superior to bupivacaine in labor analgesia.