硬膜外低浓度罗哌卡因缓解分娩疼痛临床观察

目的 观察低浓度罗哌卡因硬膜外阻滞缓解分娩疼痛的效果.方法 根据随机分组原则:220例足月产妇接受0.1%罗哌卡因(A组);200例足月产妇接受含芬太尼2 μɡ/ml的0.1%罗哌卡因的硬膜外阻滞(B组);180例足月产妇不作镇痛作为对照组(C组).在宫口至2～3 cm时,A组、B组经L3～L4硬膜外穿刺向头端置管成功...

Analgesic effect of low concentration of ropivacaine for epidural blockade

Objective To study the analgesic effect of low concentration of ropivacaine for epidural blockade.Methods 220 primiparas（group A） and 200 primiparas（group B） were given 0.1% ropivacaine and 0.1% ropivacaine plus 2 μg/ml of fentanyl for epidural blockade respectively.Another 180 primiparas did not receive epidural analgesia as controls.Epidural blockade was performed with 5ml of 1.5% lidocaine.When cervical dilatation of 2~3cm reached,10ml of 0.1% ropivacaine or ropivacaine with fentanyl was given.After 30min interval,ropivacaine 5ml/h of 0.1% or ropivacaine 0.1% with fentanyl were infused by analgesic pump in each test group continuously.The pain visual analogue scale（VAS）was recorded during the epidural blockade.Degree of motor block on modified Bromage score（MBS）was measured at the same time.The duration of labor mode of delivery and life signs were recorded.The fetal effect and the maternal uterine contractile activity were judged by continuous fetal heart rate monitoring.The neonate was assessed using Apgar scores.Results All parturients got pain relief in each test group.The VASs were 3.85±0.64,3.67±0.62 and 8.98±1.41 at active labor in ropivacaine,ropivacaine with fentanyl and control group respectively.MBSs of all parturients were mainly in class I.The active phase in each test group was significantly shorter（P0.05）than that in the control group.There was similar mode of delivery in three groups.Requirements of oxytocin in the test groups were larger（P0.05）than those in the control group.There were similar neonatal Apgar scores among the three groups.Conclusion Epidural blockade with 0.1% ropivacaine can alleviate pain of labor effectively,make active phase short,and has no marked side effect.Fentanyl with 0.1% ropivacaine does not seem to produce more advantages than ropivacaine.