罗哌卡因硬膜外滴注分娩镇痛效果及对母儿的影响

目的 :探讨罗哌卡因硬膜外滴注分娩镇痛的效果及对母婴状况的影响。方法 :72例产妇随机分为罗哌卡因组 (2 2例 ) :微量泵以 5ml h速度滴注 2g L罗哌卡因 ;布比卡因组 (2 0例 ) :微量泵以 2 .5ml h的速度滴注 1 2 5g L布比卡因加芬太尼 3～ 5mg L的混合液 ;对照组 (30例 ) :未给镇痛药。观察镇痛效果、产程、分娩方式、产后出血 ,新生儿窒息及副反应情况。结果 :罗哌卡因组和布比卡因组的镇痛效果差异无显著性 (P >0 0 5 ) ,2组的镇痛有效率分别为 90 9%和 90 0 % ,均明显优于对照组的 10 % (P <0 0 5 )。布比卡因组产程明显延长 (P <0 0 5 )且有较高的剖宫产率 (P <0 0 5 )。罗哌卡因组活跃期及第二产程与对照组比较差异均无显著性 (P >0 0 5 ) ;其自然分娩率为77 2 7% ,与对照组比较差异无显著性 (P >0 0 5 )。结论 :罗哌卡因用于分娩镇痛效果好 ,副反应少 ,对母婴无不良影响。

Epidural ropivacaine for labor analgesia

To study the effectiveness of epidural ropivacaine for laboranalgesia and its influences on both mothers andinfants. Methods: A total of 42 nullipara women were randomly divided into three groups: Rop group(22 cases) received 2 g/Lropivacaine with flow velocity of 5mL/h epidural continuous infusion. Bup group (20 cases) received 1.25 g/L bupivacaine plusfentanil 3～5 mg/L-2.5 ml/h epidural continuous infusion. The control group(30 cases) was not given any analgesia. Results:The analgesic effectiveness in two groups was snnilar ( P > 0. 05). The effectiveness rates of analgesia in Rop and Bup groups were90.9 % and 90.0% respectively, which were significantly higher than that of control group ( P < 0.05). The labor course of Bupgroup was significantly longer ( P < 0.05) and the cesarean section rate was higher ( P < 0.05). There was no significant differ-ence in the duration of active phrase and in the second stage of labor between the Rop group and control group ( P > 0.05). Therate of spontaneous delivery in Rop group was 77.2%, which had no significant difference compared with that in the control group(P > 0.05). Conclusion: Ropivacaine and bupivacaine have similar effectiveness for labor analgesia, but ropivacaine has lessside effect. It is safe for both mothers and infants in analgesia.