右美托咪定联合罗哌卡因用于硬膜外分娩镇痛的效果  

EFFECT OF DEXMEDETOMIDINE COMBINED WITH ROPIVACAINE IN EPIDURAL LABOR ANALGESIA

作　　者：赵洋[1] 辛艳[2] 刘勇波[1] 殷积慧[1] 刘英志[1] ZHAO Yang;XIN Yan;LIU Yongbo;YIN Jihui;LIU Yingzhi(Department of Anesthesiology, The Affiliated Hospital of Qingdao University, Qingdao 266003, China)

机构地区：[1]青岛大学附属医院麻醉科,山东青岛266003 [2]青岛市市立医院麻醉科

出　　处：《精准医学杂志》2018年第6期523-526,共4页Journal of Precision Medicine

基　　金：山东省自然科学基金资助项目(ZR2016HM81)

摘　　要：目的探讨右美托咪定联合罗哌卡因用于硬膜外分娩镇痛的效果。方法将80例产妇随机分为对照组(R组)与研究组(D组)2组,每组40例。R组硬膜外以0.125%的罗哌卡因进行分娩镇痛,D组硬膜外以0.125%罗哌卡因与0.5μg/kg右美托咪定联用进行分娩镇痛。对两组产妇的血压、心率、疼痛程度进行评估,记录两组产妇第一产程与第二产程的持续时间、镇静评分、运动阻滞评分,同时记录两组新生儿1min和5min Apgar评分、脐动脉血pH值及产妇并发症的发生情况。结果硬膜外镇痛后,D组视觉模拟量表评分、收缩压、舒张压、心率均明显低于R组(t=6.68～16.28,P<0.01)。两组产妇第一产程和第二产程持续时间、镇静评分、运动阻滞评分、新生儿1min Apgar评分、5min Apgar评分、脐动脉血pH值、产妇并发症发生率差异无显著性(P>0.05)。结论低浓度罗哌卡因联合右美托咪定硬膜外应用可减轻产妇的疼痛感,且产妇无明显的运动障碍、血流动力学不稳、生产过程延长及恶心与呕吐等并发症。Objective To investigate the effect of dexmedetomidine combined with ropivacaine in epidural labor analgesia. Methods A total of 80 parturients were randomly divided into control group(group R)and research group(group D),with40 parturients in each group.The parturients in group R were given 0.125%ropivacaine for epidural labor analgesia,and those in group D were given 0.125%ropivacaine combined with 0.5μg/kg dexmedetomidine for epidural labor analgesia.The two groups were compared in terms of blood pressure,heart rate,and degree of pain.The duration of the first and second stages of labor,sedation score,and motor block score were recorded,and neonatal Apgar score at 1 and 5 minutes after birth,pH value of umbilical artery blood,and complications in parturients were recorded. Results After epidural analgesia,group D had significantly lower Visual Analogue Scale score,systolic pressure,diastolic pressure,and heart rate than group R(t=6.68-16.28,P<0.01).There were no significant differences between the two groups in duration of the first and second stages of labor,sedation score,motor block score,neonatal 1-minute Apgar score,5-minute Apgar score,umbilical artery pH value,and incidence rates of maternal complications(P>0.05). Conclusion A low concentration of ropivacaine combined with dexmedetomidine for epidural analgesia can relieve the pain of parturients and does not cause movement disorders,hemodynamic instability,prolonged labor,and complications such as nausea and vomiting.

关 键 词：右美托咪啶 罗哌卡因 镇痛 产科 镇痛 硬膜外 治疗结果 

分 类 号：R614.42[医药卫生—麻醉学] R714.3[医药卫生—外科学]