鞘内注射不同剂量的罗哌卡因复合舒芬太尼的分娩镇痛效果

目的比较不同剂量罗哌卡因复合舒芬太尼鞘内注射的分娩镇痛效应。方法选择有分娩镇痛要求的初产妇共27例,随机分为9组(每组3例),而不同剂量的舒芬太尼(1.5μg、2.0μg、2.5μg)和甲磺酸罗哌卡因(2.0 mg、2.5 mg、3.0 mg)复合成9个剂量。所有产妇均行腰硬联合阻滞,每组产妇分别于鞘内注射相应剂量的舒芬太尼以及罗哌卡因,硬膜外腔置管,接硬膜外自控镇痛(PCA)泵。以镇痛起效时间、镇痛持续时间为指标,用析因设计方差分析来评估各处理组之间的镇痛效果有无差异。结果舒芬太尼复合罗哌卡因的9种剂量的镇痛起效时间之间并无差异(F=0.462,P=0.762),而每个剂量组的镇痛维持时间之间有差异,当舒芬太尼2.5μg复合罗哌卡因2.5 mg时,镇痛维持时间最长(F=3.297,P=0.034)。结论蛛网膜下腔复合用药时,以2.5μg舒芬太尼复合2.5 mg罗哌卡因的分娩镇痛效果最佳。

The effects of labor analgesia for subarachnoid-epidural analgesia with different doses of ropivacaine combined with sufentanil

Objective To compare the effects of subarachnoid-epidural analgesia with different doses of ropivacaine com- bined with sufentanil during labor analgesia. Methods 27 primipara withrequisition for labor analgesia were randomly divided into 9 groups（3 cases/group）,and there were 9 doses combined with different doses of ropivacaine（2.0 mg,2.5 mg, 3.0 mg） and sufentanil（1.5 μg,2.0 μg,2.5 μg）. All patients were injected intrathecally corresponding doses of ropiva caine combined with sufentanil after combined spinal-epidural anesthesia,then an epiduralcatheter placed for patient-con- trolled epidural analgesis. The difference of analgesia effects between the groups were evaluated with the onset and dura- tion of subarachnoid analgesia by？analysis of variance of factorial design. Results There was no significant difference for the onset in the 9 doses of ropivacaine combined with sufentanil（F = 0.462 ,P = 0.762）,but significantly difference for du- ration,especially the longest duration came from theropivacaine（2.5 mg） combined with sufentanil（2.5 μg）（F = 3.297 ,P = 0.034）. Conclusion The best effects of labor analgesia was ropivacaine （2.5 mg） combined with sufentanil （2.5μg） com- bined spinal-epidural anesthesia.