罗哌卡因或布比卡因复合芬太尼分娩镇痛的临床研究

COMPARISON OF EPIDURAL BUPIVACAINE OR ROPIVACAINE WITH FENTANYL FOR LABOR PAIN RELIEF

摘要:

目的:对比罗哌卡因与布比卡因用于硬膜外分娩镇痛的效果。方法:60例单胎初产妇随机分为0.l％罗哌卡因-芬太尼组和0.1％布比卡因-芬太尼组。采用双盲法进行视觉模拟镇痛评分（VAS）和下肢运动神经阻滞评分（MBS）。记录产程时间、生产方式、感觉阻滞平面、新生儿A评分。结果:两组产妇分娩镇痛良好,负荷量5分钟后,罗哌卡因组镇痛效果明显优于布比卡因组（P<0.01）,此后两者镇痛效果相近。罗哌卡因组的平面上升速度比布比卡因组快。罗哌卡因对运动神经的影响明显弱于布比卡因（P<0.01）,布比卡因组的器械助产率达23％。结论:罗哌卡因复合芬太尼分娩镇痛优于布比卡因。

Abstract:

Objective: To compare the analgesic effect produced by ropivacaine or bupivacaine combined with fentanyl for epidural laboring analgesia. Methods: Sixty full-term primiparous parturients were randomized to receive 0. 1 % ropivacaine -fentanyl (n =30) or 0. 1% bupivacaine-fentanyl (n =30) using a prospective double-blind design. The parturients evaluated the pain intensity according to visual analog scale ( VAS) and degree of motor block according to Modified Bromaga Score (MBS). The labor duration , delivery mode and plane of sensation block were recorded. The neonate was assessed using Apgar index. Results: All parturients in both two groups had good analgesia by using loading dose at the fifth rninue the analgesic effect of ropivacaine group was better than bupivacaine group (P <0. 01 ). From that time on ,the two groups had a similar analgesic effect. The rising speed of anesthetic plane of ropivacaine was faster than bupivacaine. The effect on motor function of ropivacaine was weaker than bupivacaine (P <0.01 ). The forceps-assisted rate of bupivacaine was 23% as compared to 10% in ropivacaine group. Conclusion: Ropivacaine is more beneficial and effective than bupivacaine for labor analgesia.