【摘要】 目的研究0.15%左旋布比卡因在不同输注速率下,用于硬膜外自控分娩镇痛的可行性及安全性。方法对80例行自然分娩的单胎足月初产妇,均采用硬膜外自控分娩镇痛,根据不同背景输注速率随机分为四组,A组输注速率为4 ml/h,B组为6 ml/h,C组为8 ml/h,D组为10 ml/h。采用视觉模拟评分(VAS)、运动神经阻滞恢复评分(改良Bromage分级)观察镇痛效果;分析产程中母体生命体征及新生儿Apgar、NACS评分,记录0.15%左旋布比卡因的总用量及使用按压给药(bolus)的次数。结果四组患者的年龄、体重及实施镇痛时的宫口大小组间比较无显著性差异(P>0.05);母体的生命体征及新生儿Apgar、NACS评分,组间比较亦无统计学意义(P>0.05);VAS评分四组均在2.4~2.6之间,无统计学差异;Bromage组间比较无统计学差异(P>0.05);A组使用bolus的次数(3.8±0.6)明显高于其它3组(P<0.01);D组的器械助产率及低血压等副反应的发生率明显高于其他三组(P<0.01)。结论研究表明0.15%左旋布比卡因可用于病人硬膜外自控分娩镇痛,且以6~8ml/h的输注速率较为安全可靠。更多还原

【Abstract】 Objective To study the feasibility and the security of 0.15% levobupivacaine for patient-controlled epidural analgesia in labour at different infusion speed.Methods Eighty healthy nulliparous parturients scheduled for patient-controlled epidural analgesia in labour,were randomly divided into 4 groups(n=20) according to different infusion speed:group I with a speed of 4 ml/h,group II with 6 ml/h,group III with 8 ml/h,group IV with 10 ml/h.The analgesic effects were assessed by using the visual analog scale(VAS),modified Bromage score.The following parameters were recorded after pump infusion: blood pressure,heart rate,respiratory rate,oxygen saturation,the adverse events and treatment regiments,the total doses of 0.15% levobupivacaine and the degrees of bolus.Results The general state of health was similar among 4 groups.The VAS score,the Bromage score of mother and the Apgar、NACS score of baby were similar among 4 groups.The degree of bolus in group I(3.8±0.6) was higher than that in other three groups.The incidence of adverse events was higher(P<0.05)in group IV.Conclusion In this study,we demonstrated that 0.15% levobupivacaine is feasible and safe at 6～8ml/h infusion speed for patient-controlled epidural analgesia in labour.更多还原