罗哌卡因与布比卡因复合芬太尼用于剖宫产术后硬膜外镇痛的比较

目的: 比较罗哌卡因和布比卡因复合芬太尼用于剖宫产术后硬膜外镇痛的效果和副作用。方法: 采用随机双盲法,将50例择期行剖宫产术的足月、单胎孕妇分为罗哌卡因组(R组)和布比卡因组(B组),每组25例。术后分别采用0.15%罗哌卡因及0.125%布比卡因,复合小剂量芬太尼(2 μg/ml)行患者自控硬膜外镇痛。观察各组术后48 h内镇痛效果、运动阻滞程度变化及恶心、呕吐、尿潴留等副作用的发生率。结果: 两组产妇术后视觉模拟评分比较差异无统计学意义(P>0.05),R组下肢运动阻滞程度低于B组(P<0.01),肌力恢复R组优于B组(P<0.01),R组副作用少。结论: 0.15%罗哌卡因混合芬太尼用于产科术后硬膜外镇痛,可获得满意的镇痛效果,且无明显毒副作用。

Comparison of ropivacaine and racemic bupivacaine in epidural analgesia after cesarean section

Objective: To compare the effects and side effects of ropivacaine and racemic bupiacaine in epidural analgesia after cesarean section.Methods: Fifty full-terms,nulliparous women undergoing cesarean section under eqidural anesthesia ware enrolled in this randomized double-blind study and were divided into ropivacaine group and racemic bupiacaine group.After operation,the patients were randomized to receive 1.5 ropivacaine(group R,n=25)or 0.125 bupivacaine(group B,n=25)for patient-controlled epidural analgesia(PCEA).The PCEA solution for the 2 groups contained fentany1 2 μg/ml.The visual analog scale(VAS),Bromage motor scale score,cardiovascular variables and side effects were recorded within 48 hours after operation.Results: There was no significant difference in VAS scores;group R was lower in extremity locomotion blockage and was superior in muscle force recovery.Conclusions: PCEA with 0.15 ropivacaine containing fentanyl 2 μg/ml provides adequate pain relief after cesarean section with little noxious or side effects.