低浓度罗哌卡因与布比卡因用于硬膜外分娩镇痛的比较

目的比较罗哌卡因和布比卡因在相同低浓度(0.1%)下硬膜外分娩镇痛的效果及其对母婴的影响。方法自愿要求分娩镇痛的初产妇60例,随机分为两组(n=30),R组给予0.1%罗哌卡因和芬太尼1μg/mL,B组给予0.1%布比卡因和芬太尼1μg/mL。采用视觉模拟评分(VAS)和改良Bromage评分评估镇痛、运动神经阻滞情况,记录产程时间、分娩方式、催产素使用率及新生儿Apgar评分。结果两组行分娩镇痛后VAS评分较镇痛前即刻均明显降低,镇痛效果良好,但两组间VAS评分差异无统计学意义(P>0.05)。R组和B组中无运动神经阻滞者分别为96.7%和40.0%,两组差异有统计学意义(P<0.05)。布比卡因器械助产率达25.0%。两组产程、催产素使用率、新生儿Apgar评分比较差异均无统计学意义(P>0.05)。结论 0.1%罗哌卡因联合芬太尼用于硬膜外分娩镇痛比布比卡因效果好。

Comparison of effects of bupivacaine and ropivacaine for epidural labor analgesia at the same low-concentration

Objective To compare the effects of ropivacaine and bupivacaine used for epidural labour analgesia at the same low-concentration（0.1%） and the influences for maternal and infant. Methods 60 voluntary primiparas requiring labour analgesia were randomly divided into two groups（n： 30）. R group were treated with 0.1% ropiva- caine combined fentanyl（1 μg/mL） ,13 group were treated with 0.1%bupivacaine combined fentanyl（1 μg/mL）. The visual analogue scale and improved Bromage score were used to evaluate the effects of analgesia and motor nerve block, while parturition time, delivery mode,oxytocin utilization rate and Apgar score of newborns were recorded. Re- sults The VAS scores of the two groups after labour analgesia were significantly lower, mean while effects were good. But VAS scores had no significant difference between the two groups（P〉0.05）. The rates ot no motor nerve block in R group and B group were 96.7%and 40.0% ,there was significant difference between the two groups（P〈0.05）. The rate of devices midwifery in B group was 25.0 %. There was no significant difference of parturition time, oxytocin utilization rate and Apgar score of newborns between the two groups. Conclusion Low-concentration ropiv- acaine（0.1%）combined fentanyl has better effect than bupivacaine for epidural labor analgesia.