小剂量罗哌卡因复合芬太尼单次腰麻在分娩镇痛的应用  

作　　者：何妹仪 李丽 

机构地区：[1]广东佛山市禅城区中心医院,528031

出　　处：《中国社区医师（医学专业）》2012年第10期127-128,共2页

摘　　要：目的:观察小剂量罗哌卡因复合芬太尼单次腰麻在宫口开大5cm以上产妇应用的效果及可行性。方法:选择宫口开大5cm以上要求分娩镇痛的孕足月、单胎的初产妇50例,均无自然分娩及椎管内麻醉禁忌证的为镇痛组(RF组),自然分娩的初产妇50例为对照组(D组),RF组给予罗哌卡因1.5mg与芬太尼17.5μg混合液0.5ml单次腰麻;D组不作任何镇痛干预。记录产妇生命体征和镇痛后的VAS评分,观察镇痛起效时间和持续时间、产程时间、分娩方式、胎心率的变化、新生儿Apgar评分及并发症的发生率。结果:RF组镇痛后的VAS评分显著低于D组(P<0.05);RF组产程较D组缩短(P<0.05);两组血压波动、新生儿Apgar评分、分娩方式及产后出血量比较差异无统计学意义(P>0.05);RF组有2例发生瘙痒,镇痛结束消失。结论:小剂量罗哌卡因复合芬太尼单次腰麻应用于宫口开大>5cm的患者可达到分娩镇痛,加速产程,且对胎儿无不良影响。Objective： To observe the lowdose ropivacaine - fentanyl Law School single spinal anesthesia in the cervix 5cm of maternal effects and feasibility of the application. Methods ： cervix 5cm above requirements pregnancy labor analgesia full - term, single births primipara 50 cases, no natural childbirth and contraindications of spinal anesthesia for analgesia group （ RF group ） , natural childbirth pfimipara 50 cases of control group （ D group） , RF Group for Law ropivaeaine 1.5mg and fentanyl 17.5μg mixture 0.5ml single spinal anesthesia, D group without any analgesic intervention. Record maternal vital signs and pain VAS score after the observed analgesic onset time and duration of labor time, mode of delivery, fetal heart rate,Apgar score and the incidence of complications. Results： RF pain VAS score after the group D was significantly lower （P 〈 0. 05 ） ; labor shorter RF group than in group D （ P 〈 O. 05 ） ; blood pressure, neo- natal Apgar score, mode of delivery, and postpartum hemorrhage between the two groups not statistically significant （ P 〉 0. 05 ） ; RF group, two cases of itching, pain end of the disappeared. Conclusion： Low - dose lopivacaine - fentanyl Law School singIe spinal anesthesia used in cervix of patients can reach more than 5cm analgesia, speed up the delivery process, and no ad- verse effects on the fetus.

关 键 词：罗哌卡因 单次腰麻 无痛分娩 产程 

分 类 号：R169.42[医药卫生—公共卫生与预防医学]