低浓度罗比卡因伍用芬太尼硬膜外分娩镇痛的临床研究

目的观察硬膜外低浓度布比卡因复合芬太尼行分娩镇痛的临床效果。方法60例健康足月头先露初产妇,随机分成3组A组为自然分娩产妇,不施行任何镇痛措施,作为对照组;B组和C组在宫口开至2~3cm时开始硬膜外注药,采用首量+持续背景量+PCA(LCP)模式。镇痛药B组采用0.125%罗比卡因,C组为0.125%罗比卡因+芬太尼(2μg/ml)。结果硬膜外镇痛对产妇的生命体征无影响。硬膜外镇痛组产妇疼痛感明显减轻,活跃期时间明显缩短,下肢活动能力存在不同程度减退。C组产妇镇痛效果明显好于B组。结论0.125%罗比卡因复合芬太尼用于硬膜外分娩镇痛起效快,镇痛时间长,而且不增加副作用,操作简单,对产妇和胎儿生理影响小,值得推广。

Clinical investigation of epidural labor pain relief by low concertration of ropivacaine combined with fentanyl

Objective:To study the effects of low concentration of ropivacaine combined with fentanyl on pain relief, the movement of lower extramites, uterotonic sensory and delivery modes during epidural analgesia in labor.Methods:Sixty healthy, primiparous, full-term, cephalic presentation parturients were randomly divided into 3 groups: Group A was normal delivery without any intervention as control; Group B and C started epidural analgesia when utero-cervical was opened about 2~3 cm.Patient-controlled epidural analgesia (PCEA) were used after the loading dose of 10 ml and followed by continuous infusion of 5 ml/h. Group B received epidural administration of 0.125% ropivacaine; Group C received epidural administration of 0.125% ropivacaine plus fentanyl (2 μg/ml).Results:Epidural labor analgesia had no any significant effect on vital signs of the parturients. The pain was significantly relieved, the time of active phases were remarkably shorted with similar motor inhibition in B, C groups compared with those in control group. The rate of good analgesia and satisfactory of parturients was significantly higher in group C than that in group B.Conclusion:0.125% ropivacaine combined with fentanyl is faster and longer without side effect and can effectively used in labor analgesia. The technique is rather simple and safe for the newborn infants and the parturients. The cost is not expensive and worth of recommendation.