左旋布比卡因复合舒芬太尼或芬太尼在分娩硬膜外自控镇痛的应用

目的探讨左旋布比卡因复合舒芬太尼硬膜外自控镇痛（PCEA）用于分娩镇痛的临床效果及安全性。方法随机选择120例美国标准协会（ASA）I-Ⅱ级初产妇，随机分为舒芬太尼组（A组）、芬太尼组（B组）、无镇痛组（C组），每组40例。A组和B组采用PCEA，C组不给予镇痛药物。观察各组不同时段视觉模拟评分（VAS）和不良反应的发生，同时记录3组产程时间、分娩方式、缩宫使用情况、产后出血量、新生儿Apgar评分。结果A、B2组和C组在PCEA20、60min及宫口开全时VAS差异有统计学意义（P〈0.05）；PCEA5min，A、B2组VAS差异有统计学意义（P〈0.05），2组Bromage评分、不良反应差异无统计学意义（P〉0.05）。3组产程时间、分娩方式、产后出血量、新生儿Apgar评分比较差异均无统计学意义（P〉0.05）。结论左旋布比卡因复合舒芬太尼或芬太尼用于分娩镇痛安全有效，对母婴无明显不良影响。

Application of levobupivacain combined with sufentanil in childbirth Patient-Controlled-Epidura-Analgesia (PCEA)

Objective To explore the clinical effect and the security of Patient-Controlled-Epidural-Analgesia （pCEA） in Childbirth analgesia. Methods 120 puerperae ASA class Ⅰ-Ⅱ were randomly divided into three groups：sufentanil group （A group）, fentanyl group （B group）, no analgesia group （C group）, each group of 40 cases. PCEA was applied in A group and B group, but not in C group. The interval vision simulation to grade （VAS） and the untoward effect occurrence of each group were observed in different time , and childbirth time, the childbirth way, the pitocin service condition, the postnatal volume of blood, newborn Apgar to grade were recorded, too. Results The VAS was different in three groups at 20, 60min of PCEA and the moment of mouth of womb opening entirely （P〈0.05）. The VAS of A and B groups has statistics differences （P〈0.05）, while the Bromage was not significantly different（P〉0.05）. The course of childbirth time, the childbirth way, the post-natal volume of blood, newborn Apgar grade had non-statistics significance in three groups（P〉0.05）. Conclusion Levobupivaeain plus stffentanil was safe and effective in childbirth Patient-Controlled-Epidural-Analgesia （PCEA） without no obvious adverse effect.