利多卡因复合盐酸罗哌卡因在产妇自控硬膜外分娩镇痛中的效果及对产妇血流指数及泌乳功能的影响  

The effect of lidocaine combined with ropivacaine hydrochloride in patient-controlled epidural labor analgesia and its effect on maternal blood flow index and lactation function

作　　者：王军 郭翠[1] 单东海 梁艳 单靓 李凡[3] WANG Jun;GUO Cui;SHAN Donghai;LIANG Yan;SHAN Liang;LI Fan(Department of Anesthesiology,People′s Hospital of Ankang City,Ankang,Shaanxi 725000,China;Department of Ultrasound,People′s Hospital of Ankang City,Ankang,Shaanxi 725000,China;Department of Obstetrics and Gynecology,People′s Hospital of Ankang City,Ankang,Shaanxi 725000,China)

机构地区：[1]陕西省安康市人民医院麻醉科,陕西安康725000 [2]陕西省安康市人民医院超声科,陕西安康725000 [3]陕西省安康市人民医院妇产科,陕西安康725000

出　　处：《检验医学与临床》2022年第20期2808-2811,共4页Laboratory Medicine and Clinic

摘　　要：目的探讨利多卡因复合盐酸罗哌卡因在产妇自控硬膜外分娩镇痛(PCEA)中的应用效果,分析两者对产妇血流指数及泌乳功能的影响。方法选取2019年5月至2021年2月该院收治足月妊娠产妇93例,依据美国麻醉医师协会(ASA)分级Ⅰ~Ⅱ级,按随机数字表法分成对照组(45例)与观察组(48例),对照组采用大剂量盐酸罗哌卡因麻醉;观察组采用利多卡因复合盐酸罗哌卡因自控镇痛。观察并记录两组麻醉效果、疼痛评分(VAS)、不同时期产妇血流指数、泌乳功能及不良反应等变化情况。结果两组麻醉起效时间、Bromage评分、T_(0)时VAS比较差异无统计学意义(P>0.05),但观察组麻醉起效到胎儿娩出时间长于对照组(P<0.05),T_(1)至T_(4)时VAS评分与不良反应发生率比对照组低(P<0.05),且泌乳功能情况较对照组更佳(P<0.05);T_(2)时,观察组血流指标值比对照组高(P<0.05)。结论利多卡因与盐酸罗哌卡因联合使用能有效提高产妇PCEA镇痛效果,降低血流,缩短泌乳时间,可以临床推广应用。Objective To explore the application effect of lidocaine combined with ropivacaine hydrochloride on the patient-controlled epidural analgesia(PCEA)of parturients,and to analyze the effects of the two on the blood flow index and lactation function of the parturients.Methods A total of 93 full-term pregnant women admitted to our hospital from May 2019 to February 2021 were selected.According to the American Association of Anesthesiologists(ASA)classificationⅠ-Ⅱ,they were divided into control group(45 cases)and observation group(48 cases)according to the random number table method.The control group was anesthetized with high-dose ropivacaine hydrochloride;the observation group was anesthetized with lidocaine combined with ropivacaine hydrochloride.Observe and record the effects of anesthesia,adverse reactions,and changes in maternal blood flow index,pain score(VAS),and lactation function in different periods of the two groups.Results There was no statistically significant difference in onset time of anesthesia,Bromage score and VAS score at T_(0) between the two groups(P>0.05),but the time from the onset of anesthesia to fetal delivery in the observation group was longer than that in the control group(P<0.05),the VAS score from T_(1) to T_(4) and the incidence of adverse reactions were lower than those of the control group(P<0.05),and the lactation function was better than that of the control group(P<0.05);at T_(2),the blood flow index value of the observation group was higher than that of the control group(P<0.05).Conclusion The combined use of lidocaine and ropivacaine hydrochloride can effectively improve the analgesic effect of maternal PCEA,and has little effect on its blood flow index and lactation function.It can be used clinically.

关 键 词：利多卡因 盐酸罗哌卡因 自控硬膜外分娩镇痛 血流指数 

分 类 号：R614.3[医药卫生—麻醉学]