雷米芬太尼用于静脉自控分娩镇痛的模式和剂量  

Mode and dosage of patient-controlled intravenous labor analgesia with remifentanil during natural delivery

作　　者：沈明坤[1] 朱爱兵[1] 许建娟[1] 

机构地区：[1]南京医科大学附属无锡妇幼保健院麻醉科,无锡市214002

出　　处：《江苏医药》2011年第17期2020-2022,共3页Jiangsu Medical Journal

基　　金：无锡市科技计划项目(CSZ00838)

摘　　要：目的探讨结合导乐分娩产妇的雷米芬太尼自控静脉分娩镇痛模式和剂量。方法 60例自然分娩初产妇随机均分成三组:A组用雷米芬太尼单次剂量0.25μg/kg,锁定时间3 min行静脉自控镇痛(PCIA);B组加用背景剂量0.025μg.kg-1.min-1;C组常规产科镇痛。比较三组产妇的镇静、镇痛效果、分娩过程和新生儿Apgar评分。结果 B组产妇的镇静、镇痛效果最好。B组VAS评分明显低于A、C组[(3.4±0.9)分vs.(6.4±1.0)分、(8.2±1.5)分。B组Ⅰ度呼吸抑制发生率与A组相仿(12.7%vs.10.2%)(P>0.05)。三组产妇的宫缩、胎心监测结果、新生儿Apgar评分、产程时间、出血量、催产素使用率、器械助产率和剖宫产率等指标均无明显差异。结论在导乐分娩的同时,用雷米芬太尼0.025μg.kg-1.min-1背景输注复合PCA雷米芬太尼0.25μg/kg是较理想的PCIA分娩镇痛模式。Objective To discuss the mode and dosage of patient-controlled intravenous labor analgesia with remifentanil during natural delivery.Methods Sixty natural childbirth primiparas were randomly divided into 3 groups with 20 cases each.At the same time of doula delivery,PCIA in group A was performed with a single dose of remifentanil 0.25 μg/kg and lockout period of 3 min.The patients in group B were given additional infusion of remifentanil 0.025 μg·kg^-1·min^-1e patients in group C were treated in a conventional way of analgesia.The indexes of sedation and analgesia,labor course and Apgar score of neonatus were compared.Results The effects of sedation and analgesia of group B were the best among three groups.Visual analogue score（VAS） was（3.4±0.9） points in group B,which was significantly lower than（6.4±1.0） points of group A or（8.2±1.5） points of groupC（P〈0.05）.The incidence of respiratory depression in group B was similar to that in group A（12.7% vs.10.2%）（P〉0.05）.There were no significant differences in the indexes of uterine contraction,fetal heart rate,Apgar score of neonates,the time of each delivery paragraph,blood loss,oxytocin application and the rate of apparatus delivery and Cesarean section among three groups.Conclusion At the same time of doula delivery,PCIA with infusion of remifentanil 0.025 μg·kg^-1·min^-1d bolus remifentanil 0.25 μg/kg in a lockout period of 3 min is a better mode for labor analgesia.

关 键 词：分娩镇痛 静脉自控镇痛 雷米芬太尼 

分 类 号：R614[医药卫生—麻醉学]