罗哌卡因联合布托啡诺或芬太尼行硬膜外分娩镇痛的效果观察

发布时间：2018-06-12 22:36

本文选题：罗哌卡因 + 布托啡诺　；参考：《中国医院药学杂志》2015年03期

【摘要】：目的:观察罗哌卡因联合布托啡诺或芬太尼行硬膜外分娩镇痛的效果及不良反应。方法:选择60例初产妇接受L2-3硬膜外穿刺置管拟行分娩镇痛,按随机数字表法分为0.1%罗哌卡因联合16μg·ml-1布托啡诺(B组)及0.1%罗哌卡因联合1μg·ml-1芬太尼(F组)。监测镇痛过程中阻滞平面和运动阻滞(Bromage评分)、镇静镇痛评分及宫缩胎心;记录麻醉起效时间、产程时间、分娩方式、缩宫素使用增加例数以及新生儿Apgar评分。记录恶心、呕吐、瘙痒、胎心减速等不良反应的发生率。结果:两组产妇平均动脉压、心率、起效时间、产程时间、分娩方式及新生儿Apgar评分无显著差异;在不良反应观察上F组皮肤瘙痒、恶心呕吐的发生率明显高于B组,差异有统计学意义(P0.05);B组有10例给药后15~30 min时镇静评分达到2分,明显高于芬太尼组,差异有统计学意义(P0.05)。两组间各时间点的VAS评分及运动神经阻滞发生的例数无显著差异。结论:布托啡诺16μg·ml-1和芬太尼1μg·ml-1联合0.10%罗哌卡因行于硬膜外分娩镇痛时镇痛效果相当,布托啡诺的不良反应更少,值得临床推广。
[Abstract]:Aim: to observe the effect and side effects of epidural analgesia with ropivacaine combined with butorphenol or fentanyl. Methods: 60 primiparas were selected to receive L2-3 epidural catheterization for labor analgesia. They were randomly divided into two groups: 0.1% ropivacaine combined with 16 渭 g ml-1 butorphenoside B) and 0.1% ropivacaine combined with 1 渭 g ml-1 fentanyl F group. During analgesia, block level and motor block Bromage score, sedative analgesia score and fetal contraction were monitored, and the onset time of anesthesia, labor process, delivery mode, increased use of oxytocin and Apgar score of newborn were recorded. The incidence of adverse reactions such as nausea, vomiting, itching and fetal heart deceleration was recorded. Results: there was no significant difference in mean arterial pressure, heart rate, onset time, labor process time, delivery mode and neonatal Apgar score between the two groups, and the incidence of skin itching, nausea and vomiting in group F was significantly higher than that in group B. The sedation score of 10 cases in group B was significantly higher than that in fentanyl group at 1530 min, which was significantly higher than that of fentanyl group (P 0.05). There was no significant difference in VAS score and motor nerve block between the two groups. Conclusion: butorphanol 16 渭 g ml-1 and fentanyl 1 渭 g ml-1 combined with 0.10% ropivacaine have the same analgesic effect during epidural labor analgesia, and the adverse reactions of butorphanol are less, so it is worth popularizing in clinic.
【作者单位】：舟山市妇幼保健院;温州医科大学附属第二医院;
【基金】：浙江省医药卫生科技项目(编号:2012KYB130) 浙江省舟山市科技局项目(编号:2013C31067)
【分类号】：R714.3

【共引文献】