低浓度罗哌卡因连续硬膜外分娩镇痛的效果刍议
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摘要
目的分析低浓度罗哌卡因连续硬膜外分娩镇痛的效果。方法方便选取该院2013年6月—2017年4月要求分娩镇痛的产妇80例,随机分为罗哌卡因组(R组),罗哌卡因联合舒芬太尼组(RS组)。另随机抽取同期没有采用分娩镇痛措施的自然分娩产妇40例为对照组(C组)。记录镇痛前后的VAS评分,不良反应及剖宫产的情况。结果 R组与RS组镇痛后VAS评分[分别为(3.0±1.3)分和(2.7±1.2)分]均低于C组(8.5±1.1)分(P<0.001);剖宫产率(分别为15.0%与17.5%)也低于C组(P=0.032、0.013)。R组镇痛后的VAS评分、不良反应及剖宫产率与RS组差异无统计学意义(P>0.05)。结论单纯低浓度罗哌卡因硬膜外注射即可获得满意的分娩镇痛效果。
Objective To analyze the effect of low-concentration ropivacaine for continuous epidural labor analgesia. Methods 80 women with labor analgesia from June 2013 to April 2017 were convenient randomly divided into ropivacaine group(R group) and ropivacaine combined with sufentanil group(RS group). Another 40 cases of natural delivery women who did not use labor analgesia during the same period were selected as the control group(group C). The VAS scores before and after analgesia, untoward effects and cesarean section were recorded. Results The VAS scores of the R group and the RS group after analgesia [(3.0±1.3)points and(2.7±1.2)points, respectively] were lower than those of the C group(8.5±1.1)points,and Their P values were <0.001 respectively. The cesarean section rate was 15.0% and 17.5%, lower than group C(P =0.032,0.013). The VAS score, untoward effects and cesarean section rate of the R group after analgesia were not different from those of the RS group(P>0.05). Conclusion The simple low-concentration ropivacaine can achieve satisfactory labor analgesia by epidural injection.
Objective To analyze the effect of low-concentration ropivacaine for continuous epidural labor analgesia. Methods 80 women with labor analgesia from June 2013 to April 2017 were convenient randomly divided into ropivacaine group(R group) and ropivacaine combined with sufentanil group(RS group). Another 40 cases of natural delivery women who did not use labor analgesia during the same period were selected as the control group(group C). The VAS scores before and after analgesia, untoward effects and cesarean section were recorded. Results The VAS scores of the R group and the RS group after analgesia [(3.0±1.3)points and(2.7±1.2)points, respectively] were lower than those of the C group(8.5±1.1)points,and Their P values were <0.001 respectively. The cesarean section rate was 15.0% and 17.5%, lower than group C(P =0.032,0.013). The VAS score, untoward effects and cesarean section rate of the R group after analgesia were not different from those of the RS group(P>0.05). Conclusion The simple low-concentration ropivacaine can achieve satisfactory labor analgesia by epidural injection.
引文
[1]沈晓凤,姚尚龙.分娩镇痛专家共识(2016版)[J].临床麻醉学杂志,2016(8):816-818.
[2]Eriksson SL,Frykholm P,Stenlund PM.A comparison of three doses of sufentalnil in combination with bupivacaineadrenaline in continous epidural analgesia during labour[J]Acta Anaesthesiol scand,2000,44:919-923.
[3]朱晓昌,娄春艳,倪小磊,等.舒芬太尼联合罗哌卡因在分娩镇痛中的应用[J].江苏医药.2016,42(19):2147-2149.
[4]王娴,夏帆,冯善武,等.单纯罗哌卡因与罗哌卡因复合舒芬太尼在硬膜外分娩镇痛中的比较[J].临床麻醉学杂志2016,32(8):761-764.
[5]林兴结,陈启忠,李君.腰一硬联合分娩镇痛中辅助使用舒芬太尼的临床研究[J].中国妇幼保健.2016,31(14):2966-2968.
[6]张洁,利爱媛.罗哌卡因及舒芬太尼不同硬膜外分娩镇痛方案对产后尿潴留的影响[J].中国现代医学杂志,2017,27(10):76-79.
[7]曹慧娟,唐郁文,陈慧,等.罗哌卡因联合两种剂量舒芬太尼镇痛用于分娩镇痛效果比较[J].中国生化药物杂志2017,6(37):262-267.
[8]时捷,车振勇,倪天军,等.高效液相色谱法检测舒芬太尼在硬脊膜外腔分娩镇痛中对新生儿的安全性[J].上海医学,2016,39(10):621-624.
[9]李铁军,蔡淑女,印春铭.舒芬太尼联合不同浓度罗哌卡因行阶梯式分娩镇痛对产程进展和新生儿的影响研究[J].中国妇幼保健,2016,31(1):185-187.
[10]鲁恒,黄绍强,胡建英,等.低浓度与超低浓度罗哌卡因间断硬膜外给药用于分娩镇痛的效果及对产科结局的影响[J].复旦学报:医学版,2017,44(4):498-502.
[2]Eriksson SL,Frykholm P,Stenlund PM.A comparison of three doses of sufentalnil in combination with bupivacaineadrenaline in continous epidural analgesia during labour[J]Acta Anaesthesiol scand,2000,44:919-923.
[3]朱晓昌,娄春艳,倪小磊,等.舒芬太尼联合罗哌卡因在分娩镇痛中的应用[J].江苏医药.2016,42(19):2147-2149.
[4]王娴,夏帆,冯善武,等.单纯罗哌卡因与罗哌卡因复合舒芬太尼在硬膜外分娩镇痛中的比较[J].临床麻醉学杂志2016,32(8):761-764.
[5]林兴结,陈启忠,李君.腰一硬联合分娩镇痛中辅助使用舒芬太尼的临床研究[J].中国妇幼保健.2016,31(14):2966-2968.
[6]张洁,利爱媛.罗哌卡因及舒芬太尼不同硬膜外分娩镇痛方案对产后尿潴留的影响[J].中国现代医学杂志,2017,27(10):76-79.
[7]曹慧娟,唐郁文,陈慧,等.罗哌卡因联合两种剂量舒芬太尼镇痛用于分娩镇痛效果比较[J].中国生化药物杂志2017,6(37):262-267.
[8]时捷,车振勇,倪天军,等.高效液相色谱法检测舒芬太尼在硬脊膜外腔分娩镇痛中对新生儿的安全性[J].上海医学,2016,39(10):621-624.
[9]李铁军,蔡淑女,印春铭.舒芬太尼联合不同浓度罗哌卡因行阶梯式分娩镇痛对产程进展和新生儿的影响研究[J].中国妇幼保健,2016,31(1):185-187.
[10]鲁恒,黄绍强,胡建英,等.低浓度与超低浓度罗哌卡因间断硬膜外给药用于分娩镇痛的效果及对产科结局的影响[J].复旦学报:医学版,2017,44(4):498-502.