罗哌卡因联用布托啡诺用于剖宫产硬膜外阻滞镇痛的疗效分析

目的 比较分析不同浓度罗哌卡因联用布托啡诺用于剖宫产硬膜外阻滞镇痛的效果,探讨其最佳浓度.方法 把1 038例行剖宫产术患者随机分为3组,A组（341例）、B组（353例）和C组（344例）.所有分娩产妇均采用硬膜外阻滞,分别给予0.125％、0.15％和0.20％罗哌卡因联用3 mg布托啡诺行硬膜外自控镇痛（PECA）.结果 B组、C组感觉阻滞起效时间和痛觉消失时间显著短于A组（P＜0.05）,B组和C组比较则无显著性差异（P＞0.05）；与A组、B组比较,C组的运动阻滞起效时间及运动恢复时间明显延长,运动阻滞程度明显较重（P＜0.05）,而A组和B组间无显著性差异（P＞0.05）；B组和C组术后2h、12 h VAS评分显著低于A组（P＜0.05）,而B组、C组之间无显著性差异（P＞0.05）,3组术后24 h VAS评分无显著性差异（P＞0.05）；A组和B组的嗜睡、恶心、呕吐、皮肤瘙痒的发生率均较C组低（P＜0.05）.结论 0.15％罗哌卡因联用3 mg布托啡诺用于剖宫产硬膜外阻滞,麻醉镇痛效果良好,且不良反应少.

Comparative study on ropivacaine combined with butorphanol in epidural anesthesia for cesarean section

Objective To explore the clinical effect and identify the optimal concentration of different concentration of ropiva- eaine in ropivaeaine combined with butorphanol in epidural anesthesia for cesarean section. Methods 1 038 patients for cesarean sec- tion were randomly divided into three groups including group A （ n = 341 ） , group B （ n = 353 ） and group C （ n = 344）. All the patients were performed by epidural anesthesia, and given 3 mg butorphanol combined with 0. 125% ,0.15% , 0.20% ropivacaine separately. Results The onset time of sense block, disappeared time of pain in group B and group C were significantly shorter than those in group A （ P 〈 0.05 ） , while there was not significantly different between group B and group C （ P 〉 0.05 ）. Compared with group A and group B, the onset time, duration and degree of motor block in group C was much longer, while there was no significantly different between group A and group B （ P 〉 0.05）. The VAS scores after cesarean section for 2 h, 12 h in group B and group C were significantly lower than that in group A（ P 〈 0.05 ） , while there was no significantly difference between Group B and Group C （P 〉 0.05 ）. The VAS scores after cesarean section for 24 h among the three groups were not statistically different （ P 〈 0.05）. The rate of side effects inclu- ding nausea and vomiting, sleepiness and itchy skin in group A and group B were lower than that in group C（ P 〈0.05 ）. Conclusion The concentration of 0.15% ropivacaine combined with 3 mg butorphanol in epidural anesthesia for cesarean section could contribute to provide good effect of anesthesia and analgesia, and reduce the side effect.