氯普鲁卡因与罗哌卡因用于硬膜外自控分娩镇痛的比较

【目的】比较10g／L氯普鲁卡因与1．25g／L罗哌卡因用于硬膜外自控分娩镇痛的效果。【方法】选择本院拟行硬膜外自控分娩镇痛的初产妇患者68例，随机分为氯普鲁卡因（A组）和罗哌卡因（B组）两组（n=34），在宫口开至2～3cm时A组给予镇痛液配方为10g／L氯普鲁卡因＋0．003g／L芬太尼；B组给予1．25g／L罗哌卡因＋0．003g／L芬太尼的硬膜外自控分娩镇痛，至第二产程开始时停止。观察并记录镇痛前、给予硬膜外负荷量后5min、30min，宫口开全时的疼痛评分（VAS）和运动神经阻滞评分（MBS）以及各产程时间，新生儿出生后Apgar评分。【结果】A组的疼痛评分较B组在给负荷量后5min低（P〈0．05），其余各时间点的疼痛评分均无差异（P〉0．05）。两组的运动神经阻滞评分、产程时间、新生儿出生后1min和5min的Apgar评分在各时间点均无缡计学意义（P〉0．05）。【结果】10g／L氯普鲁卡因分娩镇痛较1．25g／L罗哌卡因起效快，两者用于硬膜外分娩镇痛效果相当。

Comparison of the Analgesia Effect of Patient-controlled Epidural Analgesia in Labor Between Chloroprocaine and Ropivacaine

Objective] To compare the effects of epidural 10 g/L chloroprocaine and 1. 25 g/L ropivacaine by patient controlled epidural analgesia （PCEA） in labor. Methods]Sixty eight primiparous women in our hospital requesting epidural analgesia in early labor were randomly divided into the chloroprocaine group（group A） and ropivacaine group（group B）. Group A received 10g/L chloroprocaine with 0. 003g/L fentanyl. Group B received 1. 25g/L ropivaeaine with 0. 003g/L fentanyl via a patient-controlled analgesia pump. The pump was stopped at the beginning of the second stage of labor. Visual analogue scales（VAS） and modified Bromage score（MBS） were estimated and recorded at four time points such as before analgesia, 5min after epidural load ing dose, 30rain after epidural loading dose and the beginning of the second stage of labor. Duration of labor and Apgar score at lmin and 5min after parturition were also compared. Results]There was a significant difference in VAS at 5min after epidural loading dose between the two groups and no difference was observed at other time points. MBS, duration of labor and Apgar score were similar in the two groups. Conclusion] Compared with 1.25 g / L ropivacaine, 10 g/L chloroprocaine analgesia has a faster onset of action, but has the same epidural analgesia effect in labor.