0.2%氯普鲁卡因联合罗哌卡因对硬膜外分娩镇痛效果及对罗哌卡因EC_(50)的影响  

Effects of 0.2%chloroprocaine combined with ropivacaine on epidural labor analgesia and EC_(50)of ropivacaine

作　　者：黄学桂[1] 吴晓萱 陈冉 朱海娟[2] HUANG Xuegui;WU Xiaoxuan;CHEN Ran;ZHU Haijuan(Dept.of Pharmacy,Anhui Women and Children’s Medical Center/Hefei Maternal and Child Health Hospital,Hefei 230001,China;Dept.of Anesthesiology,Anhui Women and Children’s Medical Center/Hefei Maternal and Child Health Hospital,Hefei 230001,China)

机构地区：[1]安徽省妇女儿童医学中心/合肥市妇幼保健院药学部,合肥230001 [2]安徽省妇女儿童医学中心/合肥市妇幼保健院麻醉科,合肥230001

出　　处：《中国药房》2024年第14期1732-1736,共5页China Pharmacy

基　　金：国家自然科学基金项目(No.82100315);合肥市医学重点专科建设项目(No.合卫医秘[2023]72号)。

摘　　要：目的探讨0.2%氯普鲁卡因联合罗哌卡因对硬膜外分娩镇痛效果及对罗哌卡因半数有效浓度(EC_(50))的影响。方法选择2023年7月至10月在我院行阴道分娩且有镇痛需求的产妇67例,按随机数字表法分为RL组(33例)和R组(34例)。采用Dixon改良序贯法确定罗哌卡因的浓度。RL组产妇给予0.2%盐酸氯普鲁卡因注射液+盐酸罗哌卡因注射液+0.4μg/mL枸橼酸舒芬太尼注射液;R组产妇给予盐酸罗哌卡因注射液+0.4μg/mL枸橼酸舒芬太尼注射液。观察两组产妇的罗哌卡因EC_(50)、分娩镇痛效果、镇痛药总用量、镇痛满意度评分、不良反应发生情况、分娩情况及新生儿Apgar评分。结果RL组产妇的罗哌卡因EC_(50)、镇痛起效时间、补救镇痛率、会阴胀痛和爆发痛发生率、镇痛药总用量均显著低于R组,镇痛满意度评分显著高于R组(P<0.05);两组产妇的下肢麻木、下肢无力、寒战等不良反应发生率,产程时间、出血量、分娩方式及新生儿Apgar评分比较,差异均无统计学意义(P>0.05)。结论0.2%氯普鲁卡因联合罗哌卡因用于硬膜外分娩镇痛,可降低罗哌卡因的EC_(50),改善分娩镇痛效果,且安全性较好。OBJECTIVE To investigate the effects of 0.2%chloroprocaine combined with ropivacaine on epidural labor analgesia and median effective concentration(EC_(50))of ropivacaine.METHODS Totally 67 parturients who scheduled for vaginal delivery and required epidural labor analgesia were collected from our hospital from July to October 2023 and randomly divided into RL group(33 cases)and R group(34 cases).The concentration of ropivacaine was determined by modified Dixon sequential method.RL group was given 0.2%Chloroprocaine hydrochloride injection+Ropivacaine hydrochloride injection+0.4μg/mL Sufentanil citrate injection;R group was given Ropivacaine hydrochloride injection+0.4μg/mL Sufentanil citrate injection.EC_(50)of ropivacaine,analgesic effect during delivery,total dosage of analgesic drugs,analgesic satisfaction score,the incidence of adverse reactions,delivery status,and Apgar score of newborns were observed in two groups.RESULTS EC_(50)of ropivacaine,onset time,remedial analgesia rate,the incidence of perineal distension and breakthrough pain and total dosage of analgesic drugs of RL group were significantly lower than R group,and analgesic satisfaction score was significantly higher than R group(P<0.05).There was no statistical significance in the incidence of adverse reactions such as numbness,weakness,and chills in the lower limbs,or the duration of labor,amount of bleeding,mode of delivery,and Apgar score of newborns between 2 groups(P>0.05).CONCLUSIONS For epidural labor analgesia,0.2%chloroprocaine combined with ropivacaine can reduce EC_(50)of ropivacaine,improve analgesia effect and have good safety.

关 键 词：罗哌卡因 氯普鲁卡因 硬膜外 分娩镇痛 半数有效浓度 

分 类 号：R969.4[医药卫生—药理学]