罗哌卡因局部浸润麻醉对自然分娩后产妇会阴部疼痛镇痛的效果观察  

Observation on analgesic effect of ropivacaine local infiltration anesthesia on perineal pain in puerperas after spontaneous delivery

作　　者：熊亚 高宪 朱圆 王漠然 鲁开智 甯交琳 XIONG Ya;GAO Xian;ZHU Yuan;WANG Moran;LU Kaizhi;NING Jiaolin(Department of Anesthesiology,First Affiliated Hospital,Army Military Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学第一附属医院麻醉科,重庆400038

出　　处：《重庆医学》2022年第14期2449-2453,2458,共6页Chongqing medicine

基　　金：陆军军医大学拔尖/青年人才培养计划项目(LJJYDX2019-78)。

摘　　要：目的比较罗哌卡因和利多卡因局部浸润麻醉对产妇自然分娩后会阴部疼痛的镇痛效果。方法纳入2016年2月至2017年4月该院经阴道分娩并未接受其他方式分娩镇痛的足月单胎产妇112例。采用随机数表法按1∶1的比例纳入罗哌卡因组(R组)和利多卡因组(L组),每组56例。在会阴修补术前5 min进行0.75%盐酸罗哌卡因或1%盐酸利多卡因会阴部局部浸润麻醉。视觉模拟评分(VAS评分)对会阴修补术及分娩后会阴部疼痛进行评价分级,并对产妇满意度进行评价。结果L组VAS评分为0的比例在局部浸润麻醉后1 min,产后3、4、6 h低于R组(P<0.05),VAS评分<3分的比例在产后4、6 h明显低于R组(P<0.05)。R组产妇对分娩镇痛的满意度(评价为非常满意和满意)高于L组(P<0.05)。结论罗哌卡因局部浸润麻醉可以为无法接受其他分娩镇痛方式的产妇提供更快、持久的镇痛,能提高该类产妇自然分娩镇痛的满意度,保证产妇产后生活质量。Objective To compare the analgesic effects of local infiltration anesthesia by ropivacaine and lidocaine on perineal pain in puerperas after vaginal spontaneous delivery.Methods One hundred and eleven full-term single puerperas with vaginal delivery without receiving other mode of delivery analgesia in this hospital from February 2016 to April 2017 were included and divided into the ropivacaine group(R group)and lidocaine group(L group)by adopting the random number table method,56 cases in each group.0.75%ropivacaine or 1%lidocaine local infiltration anesthesia in the perineal site was performed at 5 min before perineal repair.The Visual Analog Scale(VAS)was used to conduct the grading on the perineal pain after perineal repair and delivery.Moreover,the puerpera satisfaction was evaluated.Results The proportion of the VAS score=0 at 1 min after local anesthesia and at 3,4,6 h after delivery in the group L was lower than that in the group R(P<0.05);the proportion of the VAS score<3 points at 4,6 h after delivery in the group L was significantly lower than that in the group R(P<0.05).The delivery analgesic satisfaction(very satisfaction and satisfaction)in the puerperas of the group R was higher than that in the group L(P<0.05).Conclusion Ropivacaine perineal local infiltration can provide faster and lasting analgesia to puerpera with unacceptable other analgesic mode,can increase the satisfaction in such kind of the puerperas with vaginal spontaneous delivery and guarantee the quality of life after delivery.

关 键 词：会阴部疼痛 罗哌卡因 局部麻醉 

分 类 号：R614[医药卫生—麻醉学]