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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)痛的效果觀察江西省德安縣中醫(yī)院麻醉科【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+lpg/mI芬太尼，P組0.1%鹽酸羅哌卡因+0.3mg/ml噴他佐辛，C組為對(duì)照組。在宮口開到3cm時(shí)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(shí)，會(huì)陰修補(bǔ)時(shí)VAS和改良Bromage評(píng)分，對(duì)照組記錄宮口開大3cm,宮口開全,會(huì)陰修補(bǔ)時(shí)的VAS和改良Bromage評(píng)分
2、。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(shí)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(shí)陰道出血量。結(jié)果：F組和P組產(chǎn)婦鎮(zhèn)痛前5min、鎮(zhèn)痛)510min鎮(zhèn)痛)530min>宮口開全時(shí)、會(huì)陰修補(bǔ)時(shí)VAS評(píng)分均明顯低于C組，有統(tǒng)計(jì)學(xué)差異(P<0.05)；F組和P組產(chǎn)婦第…產(chǎn)程活躍期，第二產(chǎn)程時(shí)間均明顯短于C組，有統(tǒng)計(jì)學(xué)差異(P<0.05)；F組和P組血壓下降幅度明顯高丁?C組，有統(tǒng)計(jì)學(xué)差異(P<0.05)；F組和P組催產(chǎn)素使用率明顯高于C組，中轉(zhuǎn)剖宮產(chǎn)率明顯低于C組,有統(tǒng)計(jì)學(xué)差異(P
3、V0.05)；三組器械助產(chǎn)率和胎兒娩出后2小時(shí)陰道出血量對(duì)比，無統(tǒng)計(jì)學(xué)差異(P>0.05)o結(jié)論：碩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)稈，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O【關(guān)鍵詞】羅哌卡因；芬太尼；噴他佐辛；分娩鎮(zhèn)痛；并發(fā)癥Ropivacainecombinedwithfentanylorpentazocineonlaboranalgesiaeffect[Abstract]ObjectiveStudyoflowconcentrationropivacain
4、ecombinedwithfentanylandpentazocineforanalgesiaeffectandcomplications.Method1200casesoffull-term,singleton,cephalicprimipara,dividedforthreegroups,analgesicformula:GroupF0」％ropivacainehydrochloride+1g/mlfentanyl,dezocinehisgroupP0」％ropivacainehydrochloride+0?3mg/mlspray,Cgroupasthec
5、ontrolgroup?Drivetoa3cmepidemicepiduralanalgesiainthepalacemouth,analgesiagroupofanalgesicswasrecorded5minbefore,painafter10min,30minafteranalgesia,palacemouthfiill,repairofperinealvasandmodifiedBromagescore,recordedinthecontrolspalacemouthopenbig3cm,palacemouthfull,perinealrepairof
6、vasandmodifiedBromagescore.Recordallmaternalfirstactiveperiod,thesecondstageoflaborandthelabortime,analgesiaafter30minbloodpressurecomparedtotheanalgesiaofdecreasevalueofbloodpressure(mmHg),oxytocinusage,transferrateofcesareansection,instnimentaldeliveryrate,afterthedeliveryofthefet
7、us2hoursofvaginalbleeding.ResultsFgroupandPgroupanalgesiaafter10min,30minafteranalgesia,palacemouthopenall,repairofperinealVASscorewassignificantlylowerthanthatofgroupC(P<0.05);GroupFandPthefirststagesoftheactivephaseandthesecondstageoflabortimeshorterthanthatingroupC(P<0.05);Thedec
8、reaserangeofbloodpr
