硬膜外罗哌卡因复合芬太尼用于分娩镇痛的临床研究  

Clinical Study of Low Concentration Ropivacaine and Fentanyl for Epidural Analgesia During Labor Period

作　　者：彭其才[1] 杨越波[1] 黎尚荣[2] 李小毛[1] 滕奔琦[1] 许成芳[1] 谷进[1] 

机构地区：[1]中山大学附属第三医院妇产科,广东广州510630 [2]中山大学附属第三医院麻醉科,广东广州510630

出　　处：《中山医科大学学报》2002年第4期312-313,W002,共3页Academic Journal of Sun Yat-sen University of Medical Sciences

摘　　要：【目的】研究低浓度罗哌卡因复合芬太尼采用自控硬膜外镇痛 (PCEA)方式进行分娩镇痛的临床效果及对分娩质量的影响。【方法】选择 33例产前无服用镇痛催眠药史 ,自愿要求硬膜外镇痛的足月初产妇进入研究组 ,宫口开张 2～ 3cm时行硬膜外穿刺置管 ,注入 1 5g/L的罗哌卡因与 0 0 0 2 g/L的芬太尼混合镇痛液 8～ 10mL ,使镇痛平面控制在第 10胸椎(T10 )以下 ,PCEA基础注药速率为 2～ 4mL/h ,自控镇痛量为 2mL ,锁定时间为 15min。随机选择同期非镇痛分娩产妇 5 0例作对照组。观察两组产妇疼痛情况、产程、分娩方式、分娩时间、失血量及新生儿Apgar评分。【结果】研究组产妇镇痛有效率达 10 0 % ,第一产程 (118± 5 3)min ,第二产程 (5 5± 31)min ,均较对照组明显缩短 ,顺产率 94% ,明显高于对照组 (70 % ) ,而两组产妇出血量及新生儿Apgar评分无显著差别。【结论】低浓度罗哌卡因复合芬太尼采用PCEA进行无痛分娩的临床效果好 ,能提高产科质量 ,方法简便、安全、高效。To study the clinical effect of patient controlled epidural analgesia(PCEA) with low concentration ropivacaine and fentanyl on labor, and its quality. 33 parturients with 2～3 cm cervical dilation requested epidural analgesia and no analgesics natural labor from 50 cases were enrolled into study group and control group. In analgesia group, an epidural catheter was placed at L 3/4 space when utero cervical was opened about 2～3 cm, 8～10 mL 1 5 g/L ropivacaine with 0 002 g/L fentanyl were given into epidural space as initial dose, and analgesia level was controlled under T 10 . The basic infusion rate was 2～4 mL/h, PCA volume was 2 mL, and locktime was 15 minute. Condition of pain, delivery progress, labor duration, bleeding volume and Apgar score of newborn were observed and compared. The painless efficacy in study group was 100%, labor duration was shorter than control group obviously. But no significant difference on the bleeding volume and Apgar score were observed between two groups. [Conclusion] Patient controlled epidural analgesia(PCEA) with low concentration ropicvacaine during labor period could increase the delivery quality as well as reliable?efficient and softy manner.

关 键 词：罗哌卡因 芬太尼 硬膜外镇痛 产科镇痛 

分 类 号：R713.5[医药卫生—妇产科学]