罗哌卡因复合芬太尼或喷他佐辛用于分娩镇痛的效果观察.docVIP

罗哌卡因复合芬太尼或喷他佐辛用于分娩镇痛的效果观察 戴大军 徐卫力 潘朝荣 余静平 作者单位：330400 江西省德安县中医院 【摘要】 目的 研究低浓度罗哌卡因复合芬太尼或喷他佐辛用于分娩镇痛的效果和并发症。方法 选择1200例足月，单胎，头位初产妇，，随机分为三组，镇痛药配方为：F组 0.1%盐酸罗哌卡因+1μg/ml芬太尼，P组 0.1%盐酸罗哌卡因+0.3mg/ml喷他佐辛，C组为对照组。在宫口开到3cm时行硬膜外镇痛，镇痛组记录镇痛前5 min，镇痛后10 min，镇痛后30 min，宫口开全时，会阴修补时VAS和改良Bromage评分，对照组记录宫口开大3cm，宫口开全，会阴修补时的VAS和改良Bromage评分。记录所有产妇的第一产程活跃期，第二产程和第三产程时间，镇痛后30 min血压较镇痛前基础血压下降值（mmHg），催产素使用率，中转剖宫产率，器械助产率，胎儿娩出后2小时阴道出血量。结果 F组和P组镇痛后10 min，镇痛后30 min，宫口开全时，会阴修补时VAS评分明显低于C组，F组和P组第一产程活跃期，第二产程时间短于C组，F组和P组催产素使用率高于C组，中转剖宫产率低于C组，器械助产率和胎儿娩出后2小时阴道出血量与C组比较无统计学意义。结论 硬膜外低浓度罗哌卡因复合芬太尼或喷他佐辛镇痛效果显著，不影响下肢肌力，不增加产后出血量和器械助产率，且可以缩短产程，降低剖宫产率，均可以安全地用于分娩镇痛，适合基层医院开展应用。 【关键词】 罗哌卡因；芬太尼；喷他佐辛；分娩镇痛；并发症 Ropivacaine combined with fentanyl or pentazocine on labor analgesia effect Dai Dajun Xu Weili Pan Chaorong Yu Jingping Author: 330400 Jiangxi Province Chinese medicine hospital dean County 【Abstract】Objective Study of low concentration ropivacaine combined with fentanyl and pentazocine for analgesia effect and complications. Method 1200 cases of full-term, singleton, cephalic primipara, divided for three groups, analgesic formula: Group F 0.1% ropivacaine hydrochloride + 1 g / ml fentanyl, dezocine his group P 0.1% ropivacaine hydrochloride +0.3mg/ml spray, C group as the control group. Drive to a 3cm epidemic epidural analgesia in the palace mouth, analgesia group of analgesics was recorded 5 min before, pain after 10 min, 30 min after analgesia, palace mouth full, repair of perineal vas and modified Bromage score, recorded in the controls palace mouth open big 3cm, palace mouth full, perineal repair of vas and modified Bromage score. Record all maternal first active period, the second stage of labor and the labor time, analgesia after 30 min blood pressure compared to the analgesia of decrease value of blood pressure (mmHg), oxytocin usage, transfer rate of cesarean section, instrumental delivery rate, after the delivery of the fetus 2 hours of vaginal bleeding. Results F group and P group analgesia