【摘要】 目的 观察不同剂量罗哌卡因复合小剂量芬太尼在臀位外倒转(ECV)中的应用效果。方法 选取 2016年4月-2020年11月于江门市新会区妇幼保健院收治的120例拟行ECV的产妇为研究对象,均给予罗哌卡因复合15 μg芬太尼作为腰硬联合麻醉方案;以随机数字表法分为4组,各组30例,均给予0.5%罗哌卡因鞘内注射,但每组所用剂量不同,分别为7.5 mg组、10 mg组、12.5 mg组、15 mg组。对比4组产妇ECV相关指标、不同剂量罗哌卡因VAS(视觉模拟评分法)疼痛评分及安全性。结果 120例产妇共有63例(52.50%)成功实施ECV手术。4组ECV成功率、分娩情况、剖宫产指征、出院时间、产妇满意度比较差异无统计学意义(P>0.05);10 mg组、12.5 mg组镇痛60 min、120 min时VAS评分明显低于7.5 mg组、10 mg组,差异有统计学意义(P<0.05);与12.5 mg组、15 mg组相比,7.5 mg组、10 mg组术中最低收缩压、舒张压及平均值明显高,肾上腺素、麻黄碱平均使用剂量明显低,差异有统计学意义(P<0.05)。结论 7.5 mg～15 mg罗哌卡因复合小剂量芬太尼用于ECV效果相当,但10 mg罗哌卡因在镇痛效果、安全性均较好,可作为首推剂量。更多还原

【Abstract】 Objective To observe the effects of different doses of ropivacaine compounded with low-dose fentanyl in the setting of lateral gluteal inversion (ECV).Methods Selection 120 parturients with ECV from April 2016 to November 2020,all of whom were given ropivacaine compound15μG fentanyl as a combined spinal epidural anaesthetic regimen;They were divided into four groups according to a random number table,30 each of which was administered 0.5% ropivacaine intrathecally,but the doses used were different in each group,which were 7.5 mg,10 mg,12.5 mg,15 mg.The ECV related indicators,pain scores and safety of ropivacaine VAS (visual analog scale) at different doses were compared among the 4 groups.Results A total of 63 (52.50%) of 120 parturients underwent successful ECV procedures.There were no significant differences in the ECV success rate,delivery condition,indication for cesarean section,discharge time,and maternal satisfaction among the 4 groups (P>0.05;The VAS score at 60 min and 120 min of analgesia in the 10 mg and 12.5 mg groups was significantly lower than that in the 7.5 mg and 10 mg groups (P<0.05);Compared with the 12.5 mg or 15 mg group,the lowest systolic and diastolic blood pressure and mean value during surgery were significantly higher in the 7.5 mg or 10 mg group,while the average doses of epinephrine and ephedrine used were significantly lower,with significant differences (P<0.05).Conclusion 4>low dose fentanyl from 7.5 mg to 15 mg ropivacaine compounded with low-dose fentanyl showed comparable efficacy in ECV,but 10 mg ropivacaine showed better analgesic efficacy and safety,which can be used as the first dose.更多还原