罗哌卡因与舒芬太尼不同配伍用于产妇硬膜外分娩镇痛的临床研究

目的观察0.1%与0.125%罗哌卡因复合小剂量舒芬太尼用于产妇分娩硬膜外镇痛的临床效果。方法 75例拟行硬膜外分娩镇痛的初产妇随机分为3组,每组25例,A组产妇予以0.1%罗哌卡因复合舒芬太尼0.67μg/ml硬膜外分娩镇痛,B组予0.125%罗哌卡因复合舒芬太尼0.83μg/ml硬膜外分娩镇痛,C组产妇为对照组,不予镇痛处理。观察镇痛效果（采用VAS评分）、运动阻滞程度（采用Bromage法）、生命体征、产后出血量、Apgar评分、产程、分娩方式。结果三组产妇生命体征平稳,产后出血量、Apgar评分差异无统计学意义（P〉0.05）,三组剖宫产率比较差异无统计学意义（P〉0.05）;A组与B组运动阻滞程度差异无统计学意义（P〉0.05）,镇痛效果确切,应用前后比较及与C组比较差异均有统计学意义（P〈0.01）。结论 0.1%罗哌卡因与0.125%罗哌卡因复合小剂量舒芬太尼用于硬膜外分娩镇痛安全、有效。

A clinical study of 0.1% ropivacaine combined with sufentanil and 0.125 % ropivacaine combined with sufentanil used for labor analgesia

Objective To compare the effect of 0.1% and 0.125% ropivacaine combined with sufentanil for patient-controlled epidural labor analgesia.Methods 75 nulliparous parturients were enrolled in this randomized clinical trial.A concentration of 0.1%（Group A,n=25）,0.125%（Group B,n=25） of ropivacaine with sufentanil of 0.67 μg/ml was epidurally administered by patient-controlled analgesia mode.A concentration of 0.125%（Group B,n=25） of ropivacaine with sufentanil of 0.83 μg/ml was epidurally administered by patient-controlled analgesia mode.While Group C（n=25）was the control group.Effective analgesia was defined as a visual analogue scale score was ≤30 mm.Parturients demographics,sensory and motor blockade,obstetric data,side effects,and others were also noted.Results The vital signs in group A and B were stable.There were no differences in Apgar scores,duration of labour,capacity of postpartum hemorrhage and mode of delivery among three groups（P0.05）.The degree of motor block in group A was no differences compared with that in group B（P0.05）.The effect of analgesia in group A and B was definite,the difference was significant before and after administration and also significant compared with that of group C（P0.01）.Conclusions Using patient-controlled epidural analgesia,ropivacaine of 0.1 and 0.125% with small dose of sufentanil produce good analgesia and safety for labor analgesia.