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罗哌卡因、布比卡因及左旋布比卡因复合芬太尼用于分娩镇痛的比较研究

房立峰   

  1. 唐山市中医医院
  • 收稿日期:2010-05-22 修回日期:2010-07-30 出版日期:2011-01-15 发布日期:2011-01-15
  • 通讯作者: 房立峰

Analysis of 182 cases with labor analgesia

  • Received:2010-05-22 Revised:2010-07-30 Published:2011-01-15 Online:2011-01-15

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摘要： 目的：比较罗哌卡因、布比卡因、左旋布比卡因分别复合芬太尼用于无痛分娩的疗效及安全性。方法：随机选取采用上述三种镇痛措施的足月阴道分娩产妇182例，包括：罗哌卡因组（A组）72例，布比卡因组（B组）53例，左旋布比卡因组（C组）57例。观察和记录：产妇生命体征、镇痛效果、感觉平面、下肢运动阻滞情况(modified Bromage scores, MBS 评分)、产程及分娩方式、胎心率、新生儿1分钟、5分钟Apgar 评分。结果：三组均取得良好镇痛效果，产妇全程生命体征平稳， B组第二产程显著短于A、C组，但下肢运动阻滞程度显著重于A、C组，分娩方式、新生儿Apgar 评分均无显著差异。结论：罗哌卡因、布比卡因、左旋布比卡因分别复合芬太尼用于分娩镇痛均可取得良好镇痛效果，对产妇和新生儿均无严重不良影响，布比卡因组第二产程较短，但对下肢运动阻滞程度略重。

关键词: 分娩疼痛, 芬太尼, 布比卡因, 镇痛, 硬膜外, 麻醉, 产科, 药物评价

Abstract: Analysis of 182 cases with labor analgesia 【Abstract】：Objective: To compare the analgesic effects and safety of epidural ropivacaine 、bupivacaine or levobupivacaine combined with fentanyl in labor analgesia. Methods: A total of 182 women of vaginal delivery were randomly devided into three groups: ropivacaine group (n=72, group A) 、bupivacaine group(n=53, group B) and levobupivacaine group(n=57, group C). vital signs , Analgesic efficiency，sensory levels, and motor block (Bromage score) were recorded degree of motor block(modified Bromage score) , fetal heart rate , neonatal Apgar score for 1 minute and 5minutes, duration of laboure and mode of delivery in the three groups were recorded and compared. Results: Good analgesic effects were observed in all the three groups, the vital signs in the three groups were stable, the second stage of delivery in group B was significantly shorter and MBS scores were significantly higher than those of group A and group C, there were no significant difference between groups of duration of laboure and mode of delivery、neonatal Apgar score. Conclusion: The epidural ropivacaine、bupivacaine or levobupivacaine combined with fentanyl showed good analgesic effects and safety in labor. Bupivacaine could shorten the second stage but showed greater motor block compared to ropivacaine and levobupivacaine .

Key words: labor pain, fentanyl, bupivacaine, analgesia, epidural, anesthesia, obstetrical, 药物评价