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| 0.15%罗哌卡因硬膜外给药用于分娩镇痛中爆发痛的治疗效果 |
| Analgesic effects of 0.15% ropivacaine for the breakthrough pain during labor after epidural analgesia |
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| DOI： |
| 中文关键词: 分娩镇痛 爆发痛 罗哌卡因 追加剂量 |
| 英文关键词: Labor analgesia Breakthrough pain Ropivacaine Rescue dose |
| 基金项目:江苏省临床医学专项项目(BL2014016) |
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| 摘要点击次数: 3353 |
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| 中文摘要: |
| 目的 比较不同浓度罗哌卡因单独或复合舒芬太尼硬膜外给药抑制分娩镇痛中爆发痛的临床效果。方法 选择成功施行硬膜外分娩镇痛后,第一产程中出现爆发痛的初产妇60例,ASA Ⅰ或Ⅱ级,足月单胎,随机分为0.15％罗哌卡因的追加组(A组) 和0.08％罗哌卡因复合舒芬太尼0.4 μg／ml的追加组(B组),每组30例。记录产妇VAS评分、改良Bromage评分、追加次数、罗哌卡因、舒芬太尼用量及缩宫素使用例数、产程时间、分娩方式、不良反应等。结果 与B组比较,A组爆发痛给予追加剂量20 min后VAS评分明显降低,追加次数明显减少，舒芬太尼用量明显减少，皮肤瘙痒、尿潴留等不良反应发生率明显下降；两组改良Bromage评分均为0，缩宫素使用例数、产程时间、分娩方式差异无统计学意义。结论 0.08%罗哌卡因复合舒芬太尼0.4 μg/ml背景输注8 ml/h的情况下，0.15％罗哌卡因抑制分娩镇痛后第一产程中出现的爆发痛的效果明显优于0.08％罗哌卡因复合舒芬太尼0.4 μg／ml,且不良反应少。 |
| 英文摘要: |
| Objective To compare the analgesic effects for breakthrough pain after epidural labor analgesia during vaginal delivery by different concentrations of ropivacaine with or without sufentanil. Methods A total of 60 full term nulliparous women with singleton (ASA physical status Ⅰ or Ⅱ) were included, who received successful epidural labor analgesia and experienced breakthrough pain during the first labor phrase. They were randomized into group A (n=30) and group B (n=30), rescue dose with 0.15％ pure ropivacaine and 0.08％ ropivacaine plus sufentanil 0.4 μg／ml, respectively. The VAS score, modified Bromage score, boluses of rescue dose, consumption of analgesics and oxytocin, durations of labor phrase, modes of labor, and side effects during labor were observed. Results Compared with group B, the VAS score 20 min after rescue dose for the breakthrough pain, the frequency of rescue, the dosage of sufentanil and the incidence of side effects such as itching and urine retention were significantly decreased in group A. Modified Bromage score was 0 in each group. The cases using oxytocin, labor time and childbirth way were similar. Conclusion Rescue dose of 0.15％ ropivacaine can provide better analgesic effect than those of 0.08％ ropivacaine plus sufentanil 0.4 μg／ml for the breakthrough pain during the first labor phrase, with less side effects and higher satisfaction scales. |
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