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1、.....羅哌卡因復(fù)合芬太尼或噴他佐辛用于分娩鎮(zhèn)痛的效果觀察戴大軍徐衛(wèi)力潘朝榮余靜平作者單位：330400江西省德安縣中醫(yī)院【摘要】目的研究低濃度羅哌卡因復(fù)合芬太尼或噴他佐辛用于分娩鎮(zhèn)痛的效果和并發(fā)癥。方法選擇1200例足月，單胎，頭位初產(chǎn)婦，，隨機(jī)分為三組，鎮(zhèn)痛藥配方為：F組0.1%鹽酸羅哌卡因+1μg/ml芬太尼，P組0.1%鹽酸羅哌卡因+0.3mg/ml噴他佐辛，C組為對照組。在宮口開到3cm時行硬膜外鎮(zhèn)痛，鎮(zhèn)痛組記錄鎮(zhèn)痛前5min，鎮(zhèn)痛后10min，鎮(zhèn)痛后30min，宮口開全時，會陰修補(bǔ)時VAS和改良Broma
2、ge評分，對照組記錄宮口開大3cm，宮口開全，會陰修補(bǔ)時的VAS和改良Bromage評分。記錄所有產(chǎn)婦的第一產(chǎn)程活躍期，第二產(chǎn)程和第三產(chǎn)程時間，鎮(zhèn)痛后30min血壓較鎮(zhèn)痛前基礎(chǔ)血壓下降值（mmHg），催產(chǎn)素使用率，中轉(zhuǎn)剖宮產(chǎn)率，器械助產(chǎn)率，胎兒娩出后2小時陰道出血量。結(jié)果F組和P組鎮(zhèn)痛后10min，鎮(zhèn)痛后30min，宮口開全時，會陰修補(bǔ)時VAS評分明顯低于C組，F(xiàn)組和P組第一產(chǎn)程活躍期，第二產(chǎn)程時間短于C組，F(xiàn)組和P組催產(chǎn)素使用率高于C組，中轉(zhuǎn)剖宮產(chǎn)率低于C組，器械助產(chǎn)率和胎兒娩出后2小時陰道出血量與C組比較無統(tǒng)計學(xué)意
3、義。結(jié)論硬膜外低濃度羅哌卡因復(fù)合芬太尼或噴他佐辛鎮(zhèn)痛效果顯著，不影響下肢肌力，不增加產(chǎn)后出血量和器械助產(chǎn)率，且可以縮短產(chǎn)程，降低剖宮產(chǎn)率，均可以安全地用于分娩鎮(zhèn)痛，適合基層醫(yī)院開展應(yīng)用?！娟P(guān)鍵詞】羅哌卡因；芬太尼；噴他佐辛；分娩鎮(zhèn)痛；并發(fā)癥RopivacainecombinedwithfentanylorpentazocineonlaboranalgesiaeffectDaiDajunXuWeiliPanChaorongYuJingpingAuthor:330400JiangxiProvinceChinesemedic
4、inehospitaldeanCounty學(xué)習(xí)參考.....【Abstract】ObjectiveStudyoflowconcentrationropivacainecombinedwithfentanylandpentazocineforanalgesiaeffectandcomplications.Method1200casesoffull-term,singleton,cephalicprimipara,dividedforthreegroups,analgesicformula:GroupF0.1%ropiva
5、cainehydrochloride+1g/mlfentanyl,dezocinehisgroupP0.1%ropivacainehydrochloride+0.3mg/mlspray,Cgroupasthecontrolgroup.Drivetoa3cmepidemicepiduralanalgesiainthepalacemouth,analgesiagroupofanalgesicswasrecorded5minbefore,painafter10min,30minafteranalgesia,palacemou
6、thfull,repairofperinealvasandmodifiedBromagescore,recordedinthecontrolspalacemouthopenbig3cm,palacemouthfull,perinealrepairofvasandmodifiedBromagescore.Recordallmaternalfirstactiveperiod,thesecondstageoflaborandthelabortime,analgesiaafter30minbloodpressurecompar
7、edtotheanalgesiaofdecreasevalueofbloodpressure(mmHg,oxytocinusage,transferrateofcesareansection,instrumentaldeliveryrate,afterthedeliveryofthefetus2hoursofvaginalbleeding.ResultsFgroupandPgroupanalgesiaafter10min,30minafteranalgesia,palacemouthopenall,repairofpe
8、rinealVASscorewassignificantlylowerthanthatofgroupC,groupFandpthefirststagesoftheactivephaseandthesecondstageoflabortimeshorterthanthatingroupC,FgroupandPgroupoxytoci
