布比卡因和罗哌卡因用于硬膜外分娩镇痛的研究

目的比较布比卡因和罗哌卡因硬膜外分娩镇痛的镇痛效果、运动神经阻滞状况以及对产妇和新生儿的影响。方法已临产初产妇90例,随机分为三组,I组(n=30)不接受分娩镇痛,II组(n=30)接受布比卡因复合芬太尼分娩镇痛,III组(n=30)接受罗哌卡因芬太尼分娩镇痛。分别观察产妇生命体征、产程变化、镇痛评分、改良Bromage评分和胎儿Apgar评分,记录各组分娩方式和分娩镇痛的满意度。结果II组和III组产妇在生产过程中心率、平均动脉压、呼吸频率、产程时间、镇痛评分和剖宫产发生率均低于I组(P<0.05);II组产妇改良Bromage评分高于I组和III组(P<0.05);三组胎儿Apgar评分差异无显著性(P>0.05);III组产妇的分娩镇痛的满意度高于其他两组(P<0.05)。结论适当剂量的布比卡因和罗哌卡因都可以安全用于硬膜外分娩镇痛,有利于减轻产妇的痛苦和降低剖宫产发生率;二者相比较,使用罗哌卡因硬膜外分娩镇痛效果更佳。

Comparative Study on Epidural Bupivacaine and Ropivacaine Analgesia During Labor

Objective To evaluate the efficiency and safety differences of bupivacaine and ropivacaine used in epidural analgesia,modified Bromage score,and the influences on primiparae mother and the newborn. Methods Ninety healthy,full-term,and single-fetus primigravidas were randomly assigned to: group I(n=30) without receiving any analgesia,group II(n=30) with epidural bupivacaine and fentanyl,and group III(n=30) with epidural ropivacaine and fentanyl as anesthesia.The vital signs,duration and mode of delivery,VAS,modified Bromage score,neonatal Apgar scores and the degree of satisfaction in all of the three groups were compared. Results The HR,MAP,RR,duration of delivery,VAS and the cesarean section rate in group II and group III were significantly lower than that in group I(P<0.05).Modified Bromage score in group II was significantly higher than that in group I and group III(P<0.05).There were no significant differences in neonatal Apgar scores among the three groups(P>0.05).The degree of satisfaction in group III was significantly higher than that in group I and group II(P<0.05).Conclusion Both epidural bupivacaine and ropivacaine combined with fentanyl are well tolerated as labor anesthesia,and no significant negative effects on the neonates are observed.The results suggest that(ropivacaine) is superior to bupivacaine used in labor anesthesia.