罗哌卡因配伍芬太尼自控硬膜外镇痛用于昼夜无痛分娩效果对比研究  

Diurnal Variation of Painless Delivery Efficacy of Ropivacaine plus Fentanyl for Patient-controlled Epidural Analgesia

作　　者：陈宏霞[1] 阳丽君[1] 黄瑾[1] 沈卓娜[1] 陈永珊[1] 

机构地区：[1]中山大学附属中山医院妇产科,中山市528403

出　　处：《中国医院用药评价与分析》2010年第1期57-60,共4页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:探讨罗哌卡因用于硬膜外分娩镇痛对妊娠期妇女和胎儿的影响及镇痛效果昼夜对比有无差别。方法:按产程进入活跃期的时间分为2组,A组为日间组,B组为夜间组,用低浓度罗哌卡因用于硬膜外分娩镇痛,分别观察以上2组围产期妇女的镇痛效果、产程时间、分娩方式、产后出血量以及新生儿情况。结果:2组围产期妇女年龄、身高、体重和孕周等比较,差异无显著意义(P>0.05);镇痛起效时间和麻醉完善时间B组长于A组,差异有显著意义(P<0.05);2组镇痛效果比较,差异有显著意义(P<0.05);产程时间比较(即潜伏期、活跃期、第二产程、总产程比较),差异无显著意义(P>0.05),第三产程差异有显著意义(P<0.05);2组产后出血量比较,差异无显著意义(P>0.05);2组分娩方式及催产素使用的比较,差异有显著意义(P<0.05)。结论:低浓度罗哌卡因用于硬膜外分娩镇痛是一种安全的方法,夜间使用注意监测不良事件的发生,可适当加大浓度。OBJECTIVE： To investigate the impacts of ropivacaine used for epidural anesthesia on both gravida and fetus and the diurnal variation of its analgesic efficacy. METHODS： The parturients enrolled were assigned to either daytime group（Group A） or night time group（Group B） based on the time to the active phase（labor process）.The patients were assigned to receive low concentration of ropivacaine for epidural analgesia.The analgetic effects,duration of labor,labor mode,postpartum blood loss and the condition of the neonates in the two groups were recorded.RESULTS： There were no significant differences between the two groups with regard to age,body height,body weight and the gestational weeks（P0.05）.The onset time of the anaesthetic effect and consummation time of the anaesthesia in Group B were significantly longer than inGroup A（P0.05）,and significant differences were also noted between the two groups in analgetic effect（P0.05）.In terms of labor duration,no significant differences were noted in latency period,active stage,second stage of labor and the total stage of labor（P0.05） but the differences in the third stage of labor were significant（P0.05）.No significant difference was noted in postpartum blood loss volume（P0.05） but the differences in the delivery mode and the ratio of pitocin use between the 2 group were significant（P0.05）.CONCLUSION： Low concentration of ropivacaine is safe for epidural labor analgesia,yet great attention should be paid to the monitoring of its side effect when used at night.It is preferable to increase concentration.

关 键 词：罗哌卡因 芬太尼 分娩镇痛 

分 类 号：R971.2[医药卫生—药品]