第一产程潜伏期硬膜外分娩镇痛的临床观察  

Efficacy of PCEA with Ropivcaine and Fentanyl in Latent Phrase of Labor

作　　者：周艳 田胜兰[2] 郑贵永 李元 杨世祥[3] 

机构地区：[1]广东省东莞市大朗医院麻醉科,东莞市511700 [2]武汉科技大学临床学院麻醉科,武汉市430080 [3]武汉科技大学医学院,武汉市430080

出　　处：《医药论坛杂志》2008年第21期6-8,共3页Journal of Medical Forum

摘　　要：目的观察潜伏期低浓度罗哌卡因混合芬太尼硬膜外分娩镇痛的效果及对产程、母婴的影响。方法60例单胎头位足月妊娠初产妇,随机分为镇痛组和对照组,每组30例。镇痛组产妇于宫口开1～2cm时进行硬膜外镇痛,药物为1%罗哌卡因和1μg/ml芬太尼混合液,负荷剂量6～10ml,平面控制在T10以下,30min后接PCA镇痛泵,背景输注量5ml/h,自控给药量2ml/15min,宫口开8～9cm时停用镇痛泵。对照组按产科常规处理。比较两组产妇产痛程度、产程、分娩方式、催产素使用率及新生儿Apgar评分。结果观察组镇痛效果良好,产程时间、分娩方式及新生儿Apgar评分与对照组比较无显著性差异。观察组静脉注射催产素加强宫缩较对照组多,但差异无显著性意义。结论在严密的产程监护、合理掌握药物浓度,及时产科干预下,潜伏期镇痛未增加对母儿的不良影响,临床应用安全有效。Objective To investigate the efficacy of PCEA with ropivacaine and fentanyl in latent phrase of labor and the influence of it on labor course and on both mothers and fetus. Methods Sixty nulliparas were randomly divided into analgesia group and control group, each group has thirty cases. In analgesia group, the parturieuts received 1% ropivaeaine with fentanyl 1 μg/ml when cervical dilation was about 1 - 2cm. The PCEA setting was 6 - 10ml for loading dose, and analgesia level was controlled under T10, after 30min, the PCEA pump was programmed to deliver a background dose of 5ml/h,2ml for bolus dose with 15min lockout interval. The control group received routine obstetrical treatment without analgesia. Pain intensity, the duration of labor, mode of final delivery, oxytocin consumption and Apgar score of neonatal were observed and compared. Results In analgesia group the analgesia effects was better, there were no statistically significant differences in the labor time, labor mode, Apgar score （P 〈 0. 01 ）. Oxytocin consumption in analgesia group was higher but the difference has no statistical significance. Conclusion Depending on monitoring the duration of labor, using remedy in reason and giving obstetrical intervention in time the PCEA with ropivacaine and fentanyl in latent phrase of labor is safe and efficient.

关 键 词：镇痛 硬膜外 潜伏期 产科 罗哌卡因 

分 类 号：R614.4[医药卫生—麻醉学]