不同剂量布托啡诺复合甲磺酸罗哌卡因用于中期妊娠引产硬膜外镇痛的临床研究

摘要

目的：将不同剂量布托啡诺复合甲磺酸罗哌卡因应用于中期妊娠引产硬膜外镇痛效果评价，探讨其最佳剂量。方法150例(ASA I～Ⅱ级)中孕产妇随机均分为5组（n=30），即吗啡组(M组)布托啡诺组(B 1、B 2、B 3、B 4组)。记录患者不同时点VAS评分、Ramsay评分、BCS评分及不良反应。结果（1）B 1组VAS评分分别在镇痛后10、30、90 min高于M组，B 2、B 3、B 4组与M组无明显差异；B 1组BCS评分在镇痛后10、30、90 min及清宫时低于M组，B 2、B 3、B 4组与M组无明显差异。（2）不良反应：M组恶心呕吐、皮肤瘙痒发生率高于B 1、B 2、B 3、B 4组，且差异显著。B 3，B 4组嗜睡发生率高。结论0.004%及以上浓度的布托啡诺复合甲磺酸罗哌卡因应用于中期妊娠引产的硬膜外镇痛效果确切、不良反应少，因而具有良好的临床应用价值。%Objective To study the different doses butorphanol combined with Ropivacaine mesylate applied in mid pregnancy induced labor epidural analgesia effect comparison, and discuss the best dose of it. Methods 150 cases (ASAⅠorⅡ) mid-term pregnancy induced labor maternal randomly were divided into 5 groups,30 cases in one group, control group (Group M),the experimental group (Group B 1,B 2,B 3,B 4) and PECA (Patient controlled epidural analgesia):recorded the scores of VAS grade,Ramsay,BCS and adverse reactions in two groups at different times. Results(1)VAS in Group B 1 was higher than that in Group M at 10’, 30’and 90’during analgesia. While it showed no difference between Group B 2、Group B 3、Group B 4 and Group M;BCS in Group B 1 was lower than that in Group M at 10’,30’and 90’during analgesia and curettage of uterine cavity,while it showeed no difference between Group B 2、Group B 3,Group B 4 and GroupM;(2)The incidence of complications such as nausea,vomiting and itch of skin in Group M was higher than that in Group B 1,Group B 2,Group B 3 and Group 4, and the difference was significant. Conclusion Applied in mid pregnancy induced labor epidural analgesia, 0.004%butorphanol composite Ropivacaine mesylate effect exact and hasless complication. Therefore this method has an excellent clinical.