右美托咪定在程控硬膜外间歇脉冲输注下辅助分娩镇痛的适宜浓度

目的 探讨右美托咪定复合罗哌卡因在程控硬膜外间歇脉冲注入(programmed intermittent epidural bolus,PIEB)模式下应用于分娩镇痛的适宜浓度.方法 选择2018年10月至2019年10月在四川锦欣妇女儿童医院有分娩镇痛要求的足月初产妇160例,随机分为4组,每组40例(D1、D2、D...

The optimal concentration of dexmedetomidine for assisted labor analgesia under program-controlled intermittent epidural bolus

Objective To explore the appropriate concentration of dexmedetomidine combined with ropivacaine for labor analgesia under the mode of programmed intermittent epidural bolus(PIEB).Methods 160 nulliparous parturients in Sichuan Jinxin Women and Children’s Hospital form October 2018 to October 2019 were randomly assigned to one of the four groups(Groups D1,D2,D3,and D4 received 0.2,0.3,0.4,and 0.5 ug/mL of dexmedetomidine+0.08% ropivacaine),40 cases in each group.After successful epidural puncture and confirmation of catheter position, the corresponding PIEB analgesia pump was connected.The onset time of analgesia, the time of the first addition of analgesia, the number of PCA compressions, the number of remedial analgesia, the total amount of analgesic drugs, the duration of labor, Oxytocin use rate, the mode of delivery, umbilical artery blood gas, and the Apgar score of neonates were recorded.Adverse reactions and maternal satisfaction were recorded.Results VAS scores in the four groups were significantly lower than those before analgesia, and VAS scores in the D1 group were significantly higher than those in the D2,D3 and D4 groups(P<0.05).The time of the first drug addition in group D1(248±69)min] was significantly shorter than that in group D2(318±71)min],D3(325±58)min] and D4(341±80)min],and the PCA compression ratio in group D1(67%) was significantly higher than that in group D2(31%),D3(24%) and D4(16%)(P<0.05).There were no significant differences in maternal obstetrics, neonatal conditions, and adverse reactions between the four groups(P>0.05).No motor block occurred in group D1,D2 and D3,and 2 cases occurred in group D4.Conclusion Combined with 0.08% ropivacaine, dexmedetomidine concentration at 0.3~0.4 ug/mL has a good analgesic effect and a relatively appropriate concentration when applied to labor analgesia under PIEB.