甲磺酸罗哌卡因复合芬太尼用于硬膜外分娩镇痛的临床观察

目的探讨甲磺酸罗哌卡因复合芬太尼硬膜外隙间断注药用于分娩镇痛的效果。方法选择120例ASAⅠ～Ⅱ级单胎头位足月初产妇,随机分为甲磺酸罗哌卡因硬外镇痛组(Ⅰ组),盐酸罗哌卡因镇痛组(Ⅱ组),对照组(Ⅲ组),每组40例。Ⅰ两组采用0.15%甲磺酸罗哌卡因复合2μg·mL-1芬太尼行硬外镇痛;Ⅱ两组采用0.15%盐酸罗哌卡因复合2μg·mL-1芬太尼。Ⅲ组为对照组。观察各组产妇的视觉模拟评分(VAS)、下肢运动神经阻滞MBS评分,同时观察3组的产程进展、催产素使用情况以及胎儿分娩方式、新生儿Apgar评分。结果Ⅰ、Ⅱ两组与Ⅲ组相比较,在镇痛后的产程活跃期及第二产程时的VAS评分、宫颈口扩张速率、活跃期时间方面的差异均具有统计学意义(P<0.05),Ⅰ、Ⅱ两组VAS差异无统计学意义(P>0.05);3组产妇的MBS评分、第二产程时间、分娩方式、新生儿Apgar评分差异无统计学意义(P>0.05)。结论甲磺酸罗哌卡因复合芬太尼硬膜外分娩镇痛效果良好,对母婴无明显不良影响。

Clinical observation of mesylate ropivacaine combined with fentanyl for epidural labor analgesia

OBJECTIVE To investigate effect of mesylate ropivacaine combined with fentanyl for epidural continuous infusion for labor analgesia. IVETI-IOI）S 120 cases of ASA I - II single cephalic te.n＇n primipara, randomly divided into the mesylate ropivacaine epidural analgesia group （Group I）, the hydrochloride ropivacaine analgesia group（Group II ）, control group （Group III ）, and 40 cases in each group.0.15% mesylate ropivacaine with 2μg· mL- l fentanyl was used for epidural analgesia in Group I, while. 0.15 % hydrochloride ropivacaine with 2μg· mL-I lentanyl in Group II . Group III was as the control group. Maternal visual analogue scale （VAS）, MBS score, and the birth process, oxytocin use, mode of delivery, let al neonatal Apgar score were observed among three groups. RESULTS Compared with Group III, differences of WAS scores during the active phase and the second stageof labor after analgesia, cervical orifice expansion rate, time of active phase were statistically significant in Group I, II （P〈0.05）.There was no significant difference of VAS between Group I and Group II （P 〉0.05） . And differences of maternal MBS score, duration of the second stage of labor, mode of delivery, neonatal Apgar score were not statistically significant among three groups（P 〉0.05） .CONCLUSION It was effective for the maternal with mesylate ropivacaine combined with fentanyl for epidural analgesia, however, it had no obvious adverse effects on maternals and infants.