瑞芬太尼与罗哌卡因在产科患者 自控镇痛中的应用对比.docVIP

精品论文 参考文献 瑞芬太尼与罗哌卡因在产科患者 自控镇痛中的应用对比 姜敏 何斌 陈锦 　　( 四川省成都大学附属医院 610000) 　　【摘要】 目的：比较瑞芬太尼静脉与罗哌卡因硬膜外自控分娩镇痛的有效性和安全性。方法：选择产前查适于阴道分娩自愿接受分娩镇痛 初产妇184例，ASA分级Ⅰ-Ⅱ级，单胎足月妊娠，随机分为两组，静脉瑞芬太尼自控组(A组)和硬膜外罗哌卡因组(B组)，n=94。A组瑞芬太尼以生理 盐水稀释到20mu;g/ml，初始以0.2mu;g/kg的剂量给药，逐步以0.1mu;g/kg剂量递增， 每15min调整输注速度，瑞芬太尼以 4ml/min的速度通过PCA 泵 注B 组以0.375%罗哌卡因PCEA自控镇痛。对镇痛效果、产程变化、产后出血量、顺产率、新生儿状态等项目进行观察。结果：A组和B组镇痛效果确 切，胎儿窘迫、经阴道助产和剖宫产率两组间差异均无统计学意义。A 组产妇血氧饱和度较B组降低(Plt;0.05)，产妇镇静评定A组较B组安静率更高 (Plt;0.05)。结论：瑞芬太尼静脉和罗哌卡因硬膜外自控给药都能安全有效地应用于分娩镇痛，但静脉给予瑞芬太尼产妇镇深度更高，血氧下降较 硬膜外镇痛发生率高。 　　【关键词】 瑞芬太尼；罗哌卡因；分娩镇痛 　　【中图分类号】 R2 【文献标号】 A 【文章编号】 2095-7165(2015)16-0125-01 A comparison between the patients controlled intravenous with remifentanil and epidural analgesia with ropivacaine for labor Jiang Min, He Bin, Chen Jin (Department of Anesthesiology, Affiliated Hospital of Chengdu University, Chengdu 610009, China.) [Abstract] Objective To compare the analgesic efficiency and safety of analgesic effect between patients controlled intravenous analgesia PCIA with remifentanil and epidural analgesia PCEA with ropivacaine during labour. Methods One hundred and eighty-four healthy primigravida parturients with a singleton pregnancy were studied, PCIA was used in 94 parturients (group A) and PCEA was used in 94 ones (group B). In PCEA group the epidural solution contained 0.375% ropivacaine.In PCIA group starting bolus of remifentanil was 0.2mu;g/kg with subsequent steps of 0.1mu;g/kg . Analgesic effect and the labor duration, blooding after delivery, the fetal distress were observed and compared, also the side effects of analgesia were observed Results satisfied analgesia effects were observered in group A and group B. There was no significant difference in the labor duration, blooding after delivery, the fetal distress between the two groups. There was no significant difference between the two groups in the mode of delivery. SpO2 in PCIA group was significantly lower than PCEA group at the second stage of labor and after 30min analgesia ( P