不同浓度罗哌卡因分娩镇痛对产妇血糖及β-内啡肽的影响  

The influence of Ropivacaine in various concentration on the blood glucose and β-endorphin of pregnancy women

作　　者：张跃先[1] 任利容[1] 范静[1] 

机构地区：[1]广东省深圳市宝安区妇幼保健院,518133

出　　处：《中国妇幼保健》2011年第14期2199-2200,共2页Maternal and Child Health Care of China

摘　　要：目的:探讨不同浓度罗哌卡因分娩镇痛对产妇血糖及β-内啡肽的影响。方法:随机选择150例罗哌卡因分娩镇痛的健康初产妇并分为3组,每组50例;选择50例未行分娩镇痛的健康初产妇为对照组。不同浓度罗哌卡因分娩镇痛产妇于宫口开大3～5 cm时分别接受0.1%、0.15%、0.2%罗比卡因加芬太尼1μg/ml行L2-L3硬膜外穿刺置管,首次8 ml负荷量,并采用PCEA电子泵以5 ml/h的速度持续输注。各组分别于临产前、宫口开大3 cm、宫口开大10 cm及分娩后24 h抽外周静脉血查血糖及β-内啡肽水平。结果:产妇临产后、镇痛前血糖及β-内啡肽水平较临产前增高(P<0.05);在实施硬膜外镇痛后,血糖及β-内啡肽水平下降到临产前状态,与临产前相比,差异无统计学意义(P>0.05);不同浓度罗哌卡因镇痛组间血糖及β-内啡肽水平下降幅度比较差异无统计学意义(P>0.05)。结论:0.1%罗哌卡因硬膜外镇痛可减少内源性β-内啡肽释放,稳定血糖水平。Objective：To study the influence of Ropivacaine in various concentration on the blood glucose and β-endorphin of pregnancy women.Methods：150 healthy primiparae with analgnesia delivery were chosen randomly and were divided into 3 groups,and another 50 healthy primiparae without analgesia were taken as control group.The primiparae with analgesia delivery accepted 0.1%or 0.15% or 0.2% Ropivacaine plus fentanyl 1 ug/ml during the stage of dilatation of cervix in 3～5 cm in epidural pathway.Firstly 8ml was used as unloaded dose with continuously transfusion in 5 ml/h in PCEA electron.Blood glucose and β-endorphin in peripheral venous blood were tested respectively in each group on the every timepoint of ante partum,dilatation of cervix with 3 cm,10 cm,and 24 hours postpartum.Results：The levels of blood glucose and β-endorphin increased at the stage of postpartum and predelivery,and these hormone levels decreased after analgesia with epidural pathway.There was no significant difference in the decreased amplitude among the different groups.Conclusion：Epidural analgesia with 0.1%ropivacaine can reduce the releasing of β-endorphin which can maintain the level of blood glucose.

关 键 词：罗哌卡因 分娩镇痛 血糖 Β-内啡肽 

分 类 号：R984[医药卫生—药品]