罗哌卡因合用芬太尼在产妇自控分娩镇痛的应用评价  

Evaluation of Patient Controlled Analgesia with Ropivacaine Plus Fentanyl on Labor Pain Relief

作　　者：张颖[1] 谭丽君[1] 黑子清[2] 梁润彩[1] 黄文起[2] 潘逸航[1] 

机构地区：[1]中山大学附属第一医院妇产科,广东广州510080 [2]中山大学附属第一医院麻醉科,广东广州510080

出　　处：《中山医科大学学报》2002年第4期308-311,共4页Academic Journal of Sun Yat-sen University of Medical Sciences

基　　金：广东省科委重点攻关项目基金资助项目 ( 96 2 2 0 5 0 -2 0 )

摘　　要：【目的】探讨产妇联合应用罗哌卡因和芬太尼硬膜外阻滞分娩镇痛的临床作用与安全性。【方法】选择 5 6例初产妇 ,采用微电脑镇痛泵调控硬膜外腔连续注入 1 2 5 g/L罗哌卡因 (R组 ,n =2 6 )或 1 2 5 g/L罗哌卡因加 1～ 2g/L芬太尼(RF组 ,n =30 ) ,观察产妇疼痛程度、副作用、产程时间、分娩结局、胎儿与新生儿情况 ,与未行分娩镇痛的产妇 (对照组 )进行比照。【结果】①镇痛后产痛明显缓解 ,与对照组相比差异有显著性 (P <0 0 5 ) ;②镇痛组产妇的生命体征、胎儿和新生儿情况在镇痛前后差异无显著性 (P >0 0 5 ) ,与对照组相比差异无显著性 (P >0 0 5 ) ;③R组产程显著延长 ,产程停滞发生率、产时胎方位异常发生率和钳产率较RF组和对照组高 (P <0 0 5 )。【结论】①硬膜外腔注入罗哌卡因加芬太尼或罗哌卡因可达到产时镇痛的目的 ;②两种镇痛方案均对母儿无不良影响 ,可安全用于分娩镇痛 ;③罗哌卡因配伍芬太尼可减少麻醉药用量 ,不影响产程的进展与分娩结局 ,更适用于分娩镇痛。To investigate the clinical effect and safety of epidural analgesia with ropivacaine plus fentanyl on labor pain relief. 56 cases of primipara labouring for analgesia were selected as the study groups. Puerperas were assigned to receive either 1 25 g/L of intrathecal ropivacaine plus 1～2 g/L fentanyl(RF group,n=30) or intermittent injection of 1 25 g/L ropivacaine(R group,n=26 ). The labor pain, side effects, duration and mode of delivery,outcome of delivery and fetal status were observed and compared with that of control group(none analgesia). ①Labor pain relieved more remarkably after anesthesia when compared with the control group (P<0 05); ②There were no significant differences on the status of puerperas and fetus among before anesthesia, after anesthesia and the control group; ③The first and second stage of delivery prolonged significantly in R group. The incidences of slow labor, malposition of fetal head and forceps delivery in the R group were higher than that in RF group and the control group(P<0 05).[Conclusions] ①Labor pain would be released by computer controlled intermittent epidural injections of ropivacaine or ropivacaine plus fentanly; ②Computer controlled PCEA of ropivacaine with or without fentanyl are safe to puerperas and fetus and can be used in labor pain relief; ③Ropivacaine combined with fentanyl is superior to ropivacaine alone in labor pain relief.

关 键 词：镇痛 产科 镇痛 硬膜外 罗哌卡因 芬太尼 

分 类 号：R714.3[医药卫生—妇产科学]