舒芬太尼复合罗哌卡因用于硬膜外分娩镇痛临床观察

目的观察0.1%盐酸罗哌卡因复合0.3μg/ml枸橼酸舒芬太尼硬膜外麻醉对母婴的影响。方法选择足月单胎头位妊娠初产妇60例,ASAⅠ～Ⅱ级,均自愿接受分娩镇痛,能自主使用自控镇痛泵,排除阴道分娩禁忌证及椎管阻滞禁忌证者。随机分为镇痛组和对照组,每组各30例。镇痛组予以0.1%盐酸罗哌卡因复合0.3μg/ml枸橼酸舒芬太尼混合液病人自控硬膜外镇痛（PCEA）＋背景输注（BI）,对照组产妇未行任何镇痛处理。记录、比较两组产妇的视觉模拟（VAS）评分、下肢运动神经阻滞程度、产程、产后2h内出血量、分娩方式、缩宫素使用情况和不良反应、新生儿Apgar评分。结果镇痛组VAS评分明显降低,其余指标两组间差异均无统计学意义。结论 0.1%盐酸罗哌卡因复合0.3μg/ml枸橼酸舒芬太尼病人自控硬膜外镇痛＋背景输注行分娩镇痛效果确切,对母婴影响小。

Effect of epidural analgesia with ropivacaine plus sufentanil in accouchement

Objective To estimate the effect of epidural analgesia with ropivacaine 0.1% plus sufentanil 0.3 μg/ml on obstetric and neonatal outcome.Methods Sixty women each conceiving a live single birth with vertex presentation at term were recruited in this study.They were all ASA physical status Ⅰ and Ⅱ patients and could use the pump for patient controlled analgesia easily.The patients randomized to two groups：epidural and non-epidural group with 30 women in each group.Epidural analgesia was initiated by a bolus of ropivacaine 0.1% plus sufentanil 0.3 μg/ml（6-10 ml）,followed by ropivacaine 0.1% plus sufentanil 0.3 μg/ml at the rate of 5 ml/h.Non-epidural group recepted nothing about analgesia.Visual analog scale（VAS,0-10）,motor block,duration of labor,mode of delivery,rate of using oxytocin,volume of bleeding within two hours after parturition,incidence of subsequent adverse reaction and Apgar score（1 min and 5 min） were recorded.Results VAS scores in group of epidural analgesia decreased significantly,and there were no significant differences in other indexes between the two groups.Conclusion There is no significant side effect of epidural analgesia on obstetric and neonatal outcome with ropivacaine 0.1% plus sufentanil 0.3 μg/ml administered by the mode of bolus and continuous injection.