利多卡因复合喷他佐辛用于会阴神经阻滞对孕婴的影响  

Effects of Pentazocine Combined with Lidocaine on Maternal and Infants during Episiotomy with Pudendal Block

作　　者：孟岚[1] 张红霞[1] 徐风森[1] 

机构地区：[1]山东省青岛市市立医院,山东青岛266011

出　　处：《中国医学创新》2015年第15期53-55,共3页Medical Innovation of China

摘　　要：目的:观察利多卡因复合喷他佐辛用于会阴神经阻滞侧切分娩,对孕妇和新生儿脐血血气分析的影响。方法:180例产妇均为单胎、孕足月,无妊娠合并症、并发症的初产妇,分娩前脐动脉血流监测正常,产前、产时胎心监测正常,随机数字表法分为利多卡因组(L组)和利多卡因复合喷他佐辛组(PL组),每组90例,L组用0.5%利多卡因10 m L;PL组采用0.5%利多卡因10 m L+喷他佐辛30 mg,分别行会阴神经阻滞,连续监测生命体征,记录麻醉起效时间、感觉阻滞持续时间、镇痛持续时间,采用视觉模拟评分方法(VAS)评估镇痛效果;新生儿出生后第1次呼吸前,取脐动脉血1 m L,行血气分析。记录并比较两组p H值、Pa O2、Pa CO2、HCO3-及不良反应发生情况,结果:PL组麻醉起效时间明显低于L组,阻滞时间明显长于L组,比较差异有统计学意义(P<0.05);镇痛持续时间明显延长,宫缩时VAS评分显著低于L组,比较差异有统计学意义(P<0.01);新生儿脐血血气分析各项值比较,差异无统计学意义。结论:利多卡因复合喷他佐辛行会阴神经阻滞可延长感觉阻滞和镇痛持续时间,改善镇痛效果,对新生儿脐血血气分析无影响,不良反应少,可安全用于分娩。Objective： To observe the effects of lidocaine combined with pentazocine on maternal and umbilical cord blood gas analysis during episiotomy with pudendal block.Method： The 180 puerperas were all primiparas, single birth, term pregnancy, without complication of pregnancy. Their umbilical blood stream tests were normal before delivery. Fetal heart monitorings were normal before and during delivery. They were divided into Lidocaine group （L group） and Lidocaine combined with pentazocine group （PL group） randomly. Each group included 90 cases. Lidocaine （0.5%, 10 mL） was used in L group. Pentazocine （30 mg） combined with Lidocaine （0.5%, 10 mL） was used in PL group. After pudendal block, the patients’ vital signs, the onset and druation time of anesthesia were monitored. The analgesic effects were evaluated by visual analogue scale （VAS）. Before the first breath of newborn, umbilical cord blood（1 mL） was tested for blood gas analysis. The figure of pH, PaO2,PaCO2, HCO3- and adverse reactions were recorded and compared. Result： The onset time of anesthesia in group PL were lower than group L, block was significantly longer than that in group L（P〈0.05）. Similarly, the duration time of analgesia was prolonged,the figure of VAS during uterine contraction in PL group was lower than that in L group （P〈0.01）. While umbilical cord blood gas analysis had no significant difference respectively between the two groups.Conclusion： Lidocaine lidocaine combined with Pentazocine during episiotomy with pudendal block prolonged the druation time of sensory nerve block and anesthesia. The effects of anesthesia are improved obviously. But the umbilical cord blood gas analysis is not affected. The adverse reactions are reduced. So, pentazocine combined with lidocaine could be applied during delivery safely.

关 键 词：会阴神经阻滞 喷他佐辛 产妇 分娩 脐血血气分析 

分 类 号：R614[医药卫生—麻醉学]