罗哌卡因持续分娩镇痛5801例报告  

Continuous Labor Analgesia by Ropivacaine:5801 Cases Report

作　　者：张智[1] 袁玉萍[1] 

机构地区：[1]成都市武侯区人民医院麻醉科,四川成都610041

出　　处：《四川医学》2017年第7期770-771,共2页Sichuan Medical Journal

摘　　要：目的探讨恒速球泵以罗哌卡因行硬膜外麻醉用于分娩镇痛的临床效果。方法回顾性选择恒速球泵硬膜外麻醉用于分娩镇痛产妇5801例,选择同期自然顺产产妇978例对比观察。试验组在硬膜外麻醉后注入试探剂量确定适宜麻醉平面,接4mL/h恒速球泵配以0.07%罗哌卡因和0.0l%芬太尼复合液维持镇痛。结果试验组5639例(97.2%)产妇对镇痛效果肯定,162例(2.7%)对镇痛效果不满意。试验组5801例产妇有666例(11.4%)转为剖宫产术,手术均在原麻醉下完成,且术中麻醉效果优良。试验娩出胎儿5分钟Apgar评分平均8.7分。试验组剖宫产率低于对比组(15.9%),而助产率高于对比组(2.4%),差异无统计学意义(P>0.05)。结论持续硬膜外麻醉效果确切,方法简便,不影响宫缩,对母婴均无毒性反应,产妇清醒合作,无全麻误吸之危险,可满意消除分娩痛对机体的影响。Objective To investigate the clinical efficiency of constant-dose analgesia pump epidural analgesia with ropivacaine on labor analgesia. Methods 5801 parturient women were retrospectively selected who received constant-dose analgesia pump epidural analgesia for labor analgesia. And 978 cases of natural labor were chosen as control group at the same time. The ex- perimental group was injected with an exploratory dose after epidural anesthesia to determine the appropriate level of anesthesia. And then 4mL/h constant-dose analgesia pump with 0. 07% ropivaeaine and 0. 01% fentanyl complex liquid was used to maintain analgesia. Results 5639 eases（97. 2% ） had a positive efficiency of analgesia while 162 cases（2. 7% ） were dissatisfied to analge- sia effects. 666 cases（ 11.4% ）turned to receive cesarean section that were all carried with primary anesthesia and the effect of intr- aoperative anesthesia was fine. In experiment group, fetus 5 minute Apgar score was averagely 8.7. The experiment group had a lower incidence of cesarean section（ 15. 9% ）and a higher delivery rate （2.4%）than control group with no statistical difference （ P 〉 0.05 ）. Conclusion Continuous epidural analgesia is definitely efficient, simple and convenient and has no influence in uter- ine contraction and no toxic reactions to both mothers and infants. The parturient women is conscious and cooperative without a risk of general anesthesia aspiration. And the effect of labor pain on body can be satisfactorily eliminated.

关 键 词：恒速球泵 罗哌卡因 无痛分娩 

分 类 号：R714.3[医药卫生—妇产科学]