瑞芬太尼静脉自控镇痛与罗哌卡因复合舒芬太尼硬膜外自控镇痛用于分娩镇痛的比较  

Comparisons of analgesic effect between patient controlled intravenous analgesia with remifentanil and epidural analgesia with ropivacaine/sufentanil during labour

作　　者：李兵[1] 王燕琼[1] 苏纲[1] 杜伟忠[1] 田佳[1] 黄燕[2] 

机构地区：[1]昆明市第一人民医院麻醉科,65001 [2]昆明市第一人民医院产科,650011

出　　处：《临床麻醉学杂志》2012年第8期781-783,共3页Journal of Clinical Anesthesiology

摘　　要：目的比较瑞芬太尼静脉自控镇痛(PCIA)与罗哌卡因复合舒芬太尼硬膜外自控镇痛(PCEA)在分娩镇痛中的效果及对胎儿的影响。方法选择单胎足月初产妇80例,随机均分为两组:PCEA组硬膜外腔注射0.1%罗哌卡因+0.5μg/ml舒芬太尼的混合药液10ml负荷量,然后连接硬膜外镇痛泵;PCIA组先静脉注射25μg负荷剂量的瑞芬太尼,然后连接静脉电子镇痛泵。测定患者VAS疼痛评分和Bromage评分,记录产程、分娩方式、新生儿Apgar评分及不良反应。结果镇痛后1～3h,PCEA组VAS评分明显低于PCIA组(P<0.05)。结论瑞芬太尼PCIA镇痛效果不及罗哌卡因复合舒芬太尼PCEA,但操作简单、起效快。Objective To compare the analgesic effect between patient controlled intravenous analgesia （PCIA） with remifentanil and patient controlled epidural analgesia （PCEA） with ropivacaine/sufentanil during labour. Methods Eighty full term primigravidas with a single were equally randomized into two groups： PCIA group and PCEA group. PCIA group intravenously received 25 μg remifentanil as the loading dose, and then connected with the electronic intravenous analgesic pump. PCEA group epidurally received 10 ml of liquids mixed with 0.1% ropivacaine and 0. 5 μg/ml sufentanil as the loading dose and then connected with the electronic epidural analgesic pump. Pain was evaluated by visual analogue scale （VAS） and motor blockade was assessed using modified Bromage score. Results VAS score in PCEA group was lower than in PCIA group in three hours after drug administration （P〈0. 05）. Conclusion In labour analgesia, the analgesia effect by patient controlled epidural analgesia with ropivacaine and sufentanil was more effective than patient controlled intravenous analgesia with remifentanil.

关 键 词：瑞芬太尼 患者自控硬膜外镇痛 患者自控静脉镇痛 分娩镇痛 

分 类 号：R614[医药卫生—麻醉学]