0.075%罗哌卡因复合2μg·ml^(-1)芬太尼在行走性硬膜外分娩镇痛的临床应用  

The clinical application of 0.075% ropivacaine combined with 2μg·ml^(-1) fentanyl for ambulatory epidural analgesia in labor

作　　者：陈真福[1] 吴善苏[1] 谢治己[1] 上官明化[1] 钟进财[1] 魏秀吾[1] 杨美[2] 张译珍[2] 陈健[2] 林娟[2] 

机构地区：[1]三明市第二医院麻醉科,366000 [2]三明市第二医院妇产科,366000

出　　处：《福建医药杂志》2003年第4期37-39,共3页Fujian Medical Journal

摘　　要：目的　观察 0 .0 75 %罗哌卡因复合 2μg· ml- 1 芬太尼用于可行走性硬膜外分娩镇痛的效果和对母婴的影响。方法　选择 ASA - 级足月、单胎、头位 ,估计能自然分娩、要求分娩镇痛的初产妇 10 0例 ,于宫口开 3cm时 ,行 L2 - 3硬膜外穿刺向头端置管 3cm,负荷量 12 ml～ 15 ml后连接国产怡新自控镇痛泵 ,持续背景剂量 5 ml· h- 1 、PCA量 2 ml/次 ,间隔 15 min,宫口开全时停药 ,另选同等条件不要求镇痛的初产妇 10 0例对照。结果　镇痛组感觉减退平面均在 T1 0 以下 ,VAS评分 <2 0 mm ,改良 Bromage评分为 0级 ,均可下床行走和自主排尿。产程、分娩方式、新生儿 Apgar评分两组无明显差异 (P>0 .0 5 )。结论　 0 .0 75 %罗哌卡因复合 2μg· ml- 1 芬太尼在可行走性硬膜外分娩自控镇痛中可获得满意的分娩镇痛 ,对产程、分娩方式无明显影响 。Objective To observe the efficacy of 0.075% ropivacaine combined with 2μg·ml -1 fentanyl for ambulatory epidural analgesia in labor.Methods 100 ASA physical status Ⅰ or Ⅱ primiparas with a full term singleton fetus in the vertex presentation were selected in the study.Epidural catheters were placed at L 2-3 in activelabor.A loading dose of 0.075% ropivacaine 7～12 ml combined with fentanyl 2μg·ml -1 and supplemented with patient controlled boluse(bolus dosage:2 ml,lockout time:15 min)were infused continuously by pumping until the beginning of the second stage.Another 100 cases received no analgesia and served as control group.Results All prmiparas got pain relieve obviously after analgesia(anethetic level<T 10 ,VAS score<20 mm).Unasisted walking and spontaneous micturition were observed in analgesia group.Comparing to control group,there were no significant differences in modified Bromage scroe,stage duration,mode of delivery and neonatal Apger score.Conclusion 0 075% ropivacaine combined with fentanyl 2 μg·ml -1 is suitable for walking epidural analgesia in labor.

关 键 词：分娩 镇痛 硬膜外镇痛 罗哌卡因 芬太尼 无痛分娩 临床应用 

分 类 号：R614[医药卫生—麻醉学]