不同输注速率0．15％左旋布比卡因硬膜外自控分娩镇痛的临床研究  

Clinical study on 0. 15% levobupivacaine for patient - controlled epidural analgesia in labour at different infusion speed

作　　者：索琨[1] 佘守章[1] 许立新[1] 刘焕仪[1] 谢小青[1] 

机构地区：[1]广州医学院附属广州市第一人民医院,广州510180

出　　处：《中华当代医学》2007年第6期8-9,共2页Chinese Modern Medicine

摘　　要：目的研究0．15％左旋布比卡因在不同输注速率下，用于硬膜外自控分娩镇痛的可行性及安全性。方法对80例行自然分娩的单胎足月初产妇，均采用硬膜外自控分娩镇痛，根据不同背景输注速率随机分为四组，Ⅰ组输注速率为4ml／h，Ⅱ组为6ml／h，Ⅲ组为8ml／h，IV组为10ml／h。采用视觉模拟评分（VAS）、运动神经阻滞恢复评分（改良Bromage分级）观察镇痛效果；分析产程中母体生命体征及新生儿Apgar、NACS评分，记录0．15％左旋布比卡因的总用量及使用bolus的次数。结果四组患者的年龄、体重及实施镇痛时的官口大小组间比较无显著性差异（P〉0．05）；母体的生命体征及新生儿Apgar、NACS评分。组间比较亦无统计学意义（P〉0．05）；VAS评分四组均在2．4～2．6cm之间，无统计学差异；Bromage组间比较无统计学差异（P〉0．05）；Ⅰ组使用bolus的次数（3．8f0．6）明显高于其它3组（P〈0．01）；Ⅳ组的器械助产率及低血压等副反应的发生率明显高于其他三组（P〈0．01）。结论研究表明0．15％左旋布比卡因可用于病人硬膜外自控分娩镇痛，且以6～8ml／h的背景输注速率较为安全可靠。Objective To study the feasibility and the security of 0. 15% levobupivacaine for patient - controlled epidural analgesia in labour at different infusion speed. Methods Eighty healthy nulliparous parturients scheduled for patient - controlled epidural analgesia in labour, were randomly divided into 4 groups（n =20） according to different infusion speed：group Ⅰ with a speed of 4 ml/h,group Ⅱ with 6 ml/h,group Ⅲ with 8 ml/h,group Ⅳ with 10 ml/h. The analgesic effects were assessed by using the visual analog scale （ VAS）, modified Bromage score. The following parameters were recorded after pump infusion： blood pressure,heart rate, respiratory rate,oxygen saturation, the adverse events and treament regiments, the total doses of 0. 15% levobupivacalne and the degrees of bolus. Results The general state of health were similar among 4 groups. The VAS score,the Bromage score of mother and the Apgar, NACS score of baby were similar among 4 groups. The degree of bolus in group Ⅰ （3.8 ±0. 6） were higher than other three groups. The incidence of adverse events were higher （P 〈0.05） in group Ⅳ. Concluson In this study, we demonstrated that 0.15% levobupivacaine is feasible and safety at 6 - 8ml/h infusion speed for patient - controlled epidural analgesia in labour.

关 键 词：左旋布比卡因 分娩 镇痛 硬膜外腔 

分 类 号：R971.2[医药卫生—药品]