不同浓度罗哌卡因分娩镇痛对产妇应激激素水平影响的研究  

Study on the Influence of the Stress -Related Hormone in Pregnancy Women with Ropivacaine in Various Concentration

作　　者：张跃先[1] 任利容[1] 范静[1] 

机构地区：[1]深圳市宝安区妇幼保健院,广东深圳518133

出　　处：《医学新知》2010年第3期171-173,共3页New Medicine

摘　　要：目的探讨不同浓度罗哌卡因分娩镇痛对产妇应激激素的影响。方法选择150例罗哌卡因分娩镇痛的健康初产妇，按0．1％、0．15％、0．2％浓度分为3组，每组50例；并选择50例未行分娩镇痛的健康初产妇为对照组。不同浓度罗哌卡因镇痛组于宫口开大3～5cm时分别接受0．1％、0．15％、0．2％罗哌卡因加芬太尼1μg／ml行L2—3硬膜外穿刺置管，首次8ml负荷量，并采用PCEA电子泵以5ml／h持续输注。各组分别于临产前、临产后宫口开3cm、宫口开10cm及分娩后24小时抽外周静脉血查肾上腺素、去甲肾上腺素、皮质醇含量。结果各组临产后、镇痛前肾上腺素、去甲肾上腺素、皮质醇水平较临产前增高（P〈0．05），在实施硬膜外镇痛后各激素水平下降到临产前水平（P〉0．05）；不同浓度罗哌卡因镇痛组组间激素水平下降幅度无统计学差异（P〉0．05）。结论0．1％罗哌卡因硬膜外镇痛即可有效抑制分娩痛导致的应激反应，有助于内稳态平衡。Objective To study the influence of the stress - related hormone in pregnancy women with ropivacaine in various concentration. Methods 150 healthy primiparas with analgnesia delivery were choosen randomly, which were divided into 3 groups：0.1% （n =50） ;0. 125% （n =50） ;0.2% （n =50） ,and another 50 healthy primiparas without analgesia were study as control. The primipara with analgesia delivery accepted 0. 1% or O. 125% or 0.2% ropivacaine plus fentanyl 1 ug/ml during the stage of dilatation of cervix in 3 - 5 cm in epidural pathway. Firstly 8 ml was used as unloaded dose with continuously transfusion in 5 mL/h in PCEA electron. Epinephrine, norepi- nephrine,cortisol in peripheral venous blood were tested respectively in each group on the very timepoint of ante partum, dilatation of cervix with 3 cm, 10 cm, and 24 hours postpartum. Results The levels of epinephrine, norepinephrine,and cortisol increased at the stage of postpartum and predelivery,and these hormone levels decreased after analgesia with epidural pathway. There is no significant differences in the decreased amplitude between different groups. Conclusion Epidural analgesia with 0.1% ropivacaine took effects in inhibiting the stress reaction induced by pain during delivery,which lead to the benefition in the hemostasis .

关 键 词：罗哌卡因 分娩镇痛 应激激素 测定 

分 类 号：R714.7[医药卫生—妇产科学]