罗哌卡因硬膜外自控镇痛麻醉在分娩中的应用
Application effect of the patient controlled epidural analgesia with ropivacaine during delivery
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摘要: 目的：探讨罗哌卡因硬膜外自控镇痛麻醉应用于分娩的效果。方法：根据分娩过程中的麻醉方式将140例产妇分为A组（57例）、B组（48例）和C组（35例）。A组产妇采用罗哌卡因硬膜外自控镇痛麻醉，B组产妇采用布比卡因硬膜外自控镇痛麻醉，C组产妇未采用无痛分娩术。比较3组产妇宫口开至2~3 cm（T1）和宫口全开（T2）时的VAS疼痛评分、应激反应情况以及3组会阴侧切率。结果：T1时3组产妇VAS疼痛评分差异无统计学意义（P>0.05）；与T1时相比，A组、B组VAS疼痛评分在T2时均明显降低（P<0.01），而C组则明显升高（P<0.01）；且T2时A组产妇VAS疼痛评分均明显低于B组、C组，B组VAS疼痛评分亦明显低于C组（P<0.01）。T1时3组产妇血糖、皮质醇水平差异均无统计学意义（P>0.05）；与T1时相比，3组产妇血糖、皮质醇水平在T2时均升高（P<0.05~P<0.01）；且T2时A组产妇血糖和皮质醇水平均低于B组、C组（P<0.05~P<0.01），B组产妇血糖和皮质醇水平亦均低于C组（P<0.01和P<0.05）。C组产妇会阴侧切率均明显高于A组、B组（P<0.01），而A组、B组会阴侧切率差异无统计学意义（P>0.05）。结论：罗哌卡因硬膜外自控镇痛麻醉的分娩效果良好，具有痛感轻、应激反应轻、会阴侧切率低等优点。Abstract: Objective:To explore the effects of the patient controlled epidural analgesia with ropivacaine during delivery.Methods:One hundred and forty pregnant women were divided into the group A(57 cases),group B(48 cases) and group C(35 cases) according to the anesthesia method during the delivery.The group A,group B and group C were treated with ropivacaine for patient-controlled epidural analgesia during delivery,bupivacaine for patient-controlled epidural analgesia during delivery and painless labor,respectively.The VAS score at orifice of uterus opening 2 to 3 cm(T1) and full(T2),stress response and lateral episiotomy rate between three groups were compared.Results:The differences of the VAS scores between three groups at T1 were not statistically significant(P>0.05).Compared at T1,the VAS scores in group A and group B at T2 significantly decreased(P<0.01),and which in group C significantly increased(P<0.01).At T2,the VAS score in group A was significantly lower than that in group B and group C,and the VAS score in group B was significantly lower than that in group C(P<0.01).The differences of the levels of blood glucose and Cortisol between three groups at T1 were not statistically significant(P>0.05).Compared at T1,the levels of blood glucose and Cortisol in three groups at T2 increased(P<0.05 to P<0.01).At T2,the levels of blood glucose and Cortisol in group A were lower than those in group B and group C(P<0.01 to P<0.05),and the levels of blood glucose and Cortisol in group B were lower than those in group C(P<0.01 and P<0.05).The lateral episiotomy rate in group C was higher than that in group A and group B(P<0.01),the difference of which between group A and group B was not statistically significant(P>0.05).Conclusions:The effect of patient controlled epidural analgesia with ropivacaine is good,less pain,light emergency response and low lateral episiotomy rate.
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Key words:
- anesthesia /
- obstetrics /
- ropivacaine /
- bupivacaine
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