文章摘要
肥胖与产妇分娩镇痛中局麻药用药量的相关性
Correlation between maternal obesity and local anesthetic consumption in labor analgesia
  
DOI：10.12089/jca.2021.03.004
中文关键词: 罗哌卡因  硬膜外分娩镇痛  肥胖产妇
英文关键词: Ropivacaine  Epidural labor analgesia  Obese parturients
基金项目:
作者单位E-mail
王敏 221004,徐州市,徐州医科大学麻醉学院  
李祎婷 南方医科大学金陵临床学院  
程雪梅 221004,徐州市,徐州医科大学麻醉学院  
余志阳 南京大学医学院附属金陵医院麻醉科  
谷中亚 南京大学医学院附属金陵医院麻醉科  
段满林 221004,徐州市,徐州医科大学麻醉学院 dml9001@163.com 
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中文摘要:
      
目的 探讨产妇肥胖与硬膜外分娩镇痛中局麻药用药量的相关性，为肥胖产妇分娩镇痛提供参考。
方法 回顾性分析2018年9月至2019年12月于本院接受硬膜外分娩镇痛产妇，年龄21～35岁，BMI 18.5～40.0 kg/m2，ASA Ⅰ或Ⅱ级，根据产妇BMI分为非肥胖（18.5～29.9 kg/m2）和肥胖（BMI≥30 kg/m2）。根据镇痛期间每小时罗哌卡因用药量的三分位数将产妇分为三组：低剂量组（L组）、中剂量组（M组）、高剂量组（H组）。采用有序多分类Logistic回归模型分析产妇肥胖与分娩镇痛期间每小时罗哌卡因用药量之间的相关性。
结果 292例产妇纳入分析，肥胖产妇50例（17.1%）。L组和M组产妇肥胖比例明显低于H组（P<0.05）。多因素Logistic回归分析显示，产妇肥胖与分娩镇痛期间每小时罗哌卡因用药量呈显著负相关（OR=0.445，95%CI 0.220～0.901，P=0.024）。
结论 产妇肥胖与分娩镇痛期间每小时罗哌卡因用药量呈显著负相关。
英文摘要:
      
Objective To explore the correlation between maternal obesity and local anesthetic consumption in epidural labor analgesia, and to provide guidance for epidural labor analgesia for obese parturients.
Methods Parturients who aged 21-35 years, ASA physical status Ⅰ or Ⅱ, BMI 18.5-40.0 kg/m2, and received epidural labor analgesia in Jinling Hospital from September 2018 to December 2019 were included in this retrospective analysis. Parturients were stratified into non-obese group (BMI 18.5-29.9 kg/m2) and obese group (BMI ≥ 30 kg/m2) based on BMI. The primary outcome was the consumption of ropivacaine per hour during analgesia. According to the tertiles of the primary outcome, the parturients were divided into three groups: low-dose group (group L), middle-dose group (group M), and high-dose group (group H). The association between maternal obesity and hourly ropivacaine consumption during analgesia was analyzed with an ordinal logistic regression model.
Results A total of 292 parturients were included in the final analysis, of which 50 were obese (17.1%). The proportion of obese women in groups L and M was significantly lower than that in group H (P < 0.05). Multivariate ordinal logistic regression analysis showed that compared with non-obese parturients, obese parturients had a significantly lower risk of higher hourly ropivacaine consumption (OR = 0.445, 95%CI 0.220 - 0.901, P = 0.024).
Conclusion Maternal obesity was significantly associated with the decrease of hourly ropivacaine consumption during epidural labor analgesia.
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