罗哌卡因硬膜外滴注分娩镇痛效果及对母儿的影响

摘要

To study the effectiveness of epidural ropivacaine for laboranalgesia and its influences on both mothers andinfants. Methods: A total of 42 nullipara women were randomly divided into three groups: Rop group(22 cases) received 2 g/Lropivacaine with flow velocity of 5mL/h epidural continuous infusion. Bup group (20 cases) received 1.25 g/L bupivacaine plusfentanil 3～5 mg/L-2.5 ml/h epidural continuous infusion. The control group(30 cases) was not given any analgesia. Results:The analgesic effectiveness in two groups was snnilar ( P > 0. 05). The effectiveness rates of analgesia in Rop and Bup groups were90.9 % and 90.0% respectively, which were significantly higher than that of control group ( P < 0.05). The labor course of Bupgroup was significantly longer ( P < 0.05) and the cesarean section rate was higher ( P < 0.05). There was no significant differ-ence in the duration of active phrase and in the second stage of labor between the Rop group and control group ( P > 0.05). Therate of spontaneous delivery in Rop group was 77.2%, which had no significant difference compared with that in the control group(P > 0.05). Conclusion: Ropivacaine and bupivacaine have similar effectiveness for labor analgesia, but ropivacaine has lessside effect. It is safe for both mothers and infants in analgesia.%目的：探讨罗哌卡因硬膜外滴注分娩镇痛的效果及对母婴状况的影响。方法：72例产妇随机分为罗哌卡因组(22例)：微量泵以5ml／h速度滴注2g/L罗哌卡因；布比卡因组(20例)：微量泵以2．5ml／h的速度滴注1．25g/L布比卡因加芬太尼3～5mg/L的混合液；对照组(30例)：未给镇痛药。观察镇痛效果、产程、分娩方式、产后出血，新生儿窒息及副反应情况。结果：罗哌卡因组和布比卡因组的镇痛效果差异无显著性(P>0．05)，2组的镇痛有效率分别为90．9％和90．0％，均明显优于对照组的10％(P<0．05)。布比卡因组产程明显延长(P<0．05)且有较高的剖宫产率(P<0．05)。罗哌卡因组活跃期及第二产程与对照组比较差异均无显著性(P>0．05)；其自然分娩率为77．27％，与对照组比较差异无显著性(P>0．05)。结论：罗哌卡因用于分娩镇痛效果好，副反应少，对母婴无不良影响。