0.1%罗哌卡因复合舒芬太尼用于无痛分娩对母婴一氧化氮及皮质醇的影响  

The effect of ropivacaine plus sufentanil on maternal and neonatal serum nitric oxide and cortisol in patient with controlled epidural analgesia during labor

作　　者：杨世辉[1] 黄希照[1] 胡祖荣[1] 贾杰[1] 黎昆伟[1] 邓恋[1] 

机构地区：[1]广东省妇幼保健院麻醉科,广州510010

出　　处：《广东医学》2012年第6期851-853,共3页Guangdong Medical Journal

基　　金：广东省科技计划项目(编号:2009B080701052)

摘　　要：目的研究0.1%罗哌卡因复合舒芬太尼硬膜外自控镇痛(PCEA)在无痛分娩中的镇痛效果和对母婴的安全性。方法选择ASAⅠ～Ⅱ级初产妇100例,随机分为P组和C组。P组经硬膜外注入0.1%罗哌卡因复合舒芬太尼0.5μg/mL混合液5 mL观察5～10 min,确认导管在硬膜外腔后,再注入上述混合液10 mL为负荷剂量,连接自控镇痛泵。C组为未实施镇痛组。两组均观察血压、脉搏、呼吸、SpO2、胎心率、分娩情况、新生儿情况、不良反应及并发症。P组检测镇痛前后而C组则监测入产室及其后1 h产妇静脉血。新生儿娩出后抽取脐静脉血检测一氧化氮(NO)及皮质醇的浓度。P组进行镇痛程度及运动阻滞程度评分。结果实施无痛分娩产妇疼痛缓解,镇痛前后一般生命体征均维持平稳,比较差异无统计学意义(P>0.05)。P组镇痛前后与C组相应时点VAS评分差异有统计学意义(P<0.05)。分娩情况比较差异无统计学意义(P>0.05)。两组均未观察到不良反应或椎管内麻醉的并发症。P组分娩后NO无明显变化,皮质醇浓度降低(P<0.05);C组NO下降(P<0.05),皮质醇浓度升高(P<0.05)。结论用0.1%罗哌卡因复合舒芬太尼PCEA用于无痛分娩,安全有效,降低皮质醇浓度,延缓母婴NO水平降低。Objective To observe the analgesic efficacy and safety of ropivacaine （0. 1% ） plus sufentani] （0.5 ug/mL） for parturients with controlled epidural analgesia during labor. Methods One hundred healthy primiparas were randomized to two groups： PCEA group and control group. In the PCEA group, 15 mL loading dose and continuous back- ground infusion by 5 mL/h of ropivacaine （0. 1% ） plus fentanyl （0. 05 μg/mL） , with controlled epidural analgesia were given to subjects. Maternal vital signs, visual analog scale （VAS） score, modified bromage scale （MBS） of motor block neonate and neonatal Apgar scores were recorded. Serum nitric oxide and cortisol of mothers and neonates were assessed. Results There was no significant difference in maternal demographic data, duration of labor, mode of delivery, Apgar score, and maternal vital signs between the two groups. VAS score was significantly higher in control group than that in PCEA group （ 7.92 ± 1.46 vs 0. 73 ±0. 64, P 〈 0. 05 ）. Significant elevation of neonatal serum nitric oxide was revealed in PCEA group. No adverse event was recorded. Conclusion Ropivacaine （0. 1% ） plus sufentanil （0. 5 μg/mL） given via patient - controlled epidural anesthesia [ Key words ]

关 键 词：罗哌卡因 舒芬太尼 无痛分娩 一氧化氮 皮质醇 

分 类 号：R714.3[医药卫生—妇产科学]