罗哌卡因对行会阴侧切缝合术产妇术后镇痛的研究  

Effect of ropivacaine on postoperative analgesia in primiparous women after lateral episiotomy

作　　者：熊玮[1] 祝彩霞[2] 牛刚[2] 黄雄庆[1] Xiong Wei;Zhu Caixia;Niu Gang;Huang Xiongqing(Department of Anesthesiology,the First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China)

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

出　　处：《新医学》2018年第9期674-676,共3页Journal of New Medicine

摘　　要：目的探讨罗哌卡因对行会阴侧切缝合术的经阴道分娩产妇术后镇痛效果和安全性。方法选择经阴道分娩且行会阴侧切缝合术的306例足月单胎初产妇,随机分为利多卡因组和罗哌卡因组,每组各153例产妇,在会阴侧切缝合术前分别应用20 ml 0.2%利多卡因和20 ml 0.2%罗哌卡因进行会阴阻滞麻醉,应用疼痛视觉模拟评分法(VAS)评估产妇术后疼痛程度,观察2组的不良反应发生情况。结果 2组产妇的年龄、分娩孕周、麻醉分级、顺产率和新生儿出生体质量比较差异均无统计学意义(P均>0.05)。罗哌卡因组产妇在产后0、2、6、12、24 h的VAS分值均低于利多卡因组(P均<0.001)。2组产妇的低血压、恶心呕吐、感觉异常、口干发生率比较差异均无统计学意义(P均>0.05)。结论罗哌卡因用于会阴侧切缝合术的阻滞麻醉,有利于减轻产妇的术后疼痛,且安全性高。Objective To explore the analgesic effect and adverse events of ropivacaine upon postoperative pain in pregnant women undergoing lateral episiotomy. Methods A total of 306 primiparous women with full-term singleton pregnancy undergoing vaginal delivery and lateral episiotomy were randomly assigned into the lidocaine （n=153） and ropivacaine groups （n=153）. Prior to lateral episiotomy, perineal nerve block anesthesia was delivered by 20 ml of 0.2% lidocaine and ropivacaine between two groups. The degree of postoperative pain was assessed by visual analogue scale （VAS）. The incidence of postoperative adverse events was observed. Results Age, gestational week, classification of anesthesia, vaginal delivery rate and neonatal birth weight did not significantly differ between two groups （all P〉0.05）. In the ropivacaine group, the VAS scores at 0-, 2-, 6-, 12- and 24-h after labor were significantly lower compared with those in the lidocaine group （all P 〈 0.001）. The incidence of hypotension, nausea, vomiting, abnormal sensation and dry mouth did not significantly differ between two groups （all P〉0.05）. Conclusion Application of ropivacaine in the block anesthesia after lateral episiotomy can mitigate postoperative pain and yield less adverse events compared with lidocaine.

关 键 词：罗哌卡因 会阴侧切缝合术 产妇 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]