国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2011年
1期
10-13
,共4页
罗哌卡因%会阴侧切缝合术%镇痛效果
囉哌卡因%會陰側切縫閤術%鎮痛效果
라고잡인%회음측절봉합술%진통효과
Ropivacaine%Lateral episiotomy perineorrhaphy%Analgesic effect
目的 比较罗哌卡因与利多卡因运用于会阴侧切缝合术中与术后的镇痛效果.方法 选择需行会阴侧切术且无手术禁忌症、无产科并发症、无精神疾患的产妇80例,随机分为实验组和对照组,每组各40例.实验组运用0.375%罗哌卡因20 ml,对照组运用1%利多卡因20 ml,分别在会阴侧切前行阴部神经阻滞麻醉与皮下浸润麻醉.观察比较两组产妇在术中与术后的疼痛程度、麻醉持续时间、新生儿Apgar's评分情况、有无产后尿潴留等不良反应.结果 实验组在缝合术中、用药后1h、2 h、4h、8 h的疼痛VAS评分均低于对照组,F=6.01(P＜0.05),提示实验组在会阴侧切缝合术的镇痛效果与镇痛持续时间明显优于对照组.新生儿1分钟、5分钟的Apgar's评分两组无差别,t=1.863(P＞0.05).未发现对产后出血、尿潴留等不良反应的不良影响.结论 罗哌卡因具有镇痛作用强和持续时间长等优点,效果优于利多卡因.在会阴侧切术中应用小剂量罗哌卡因行会阴部神经阻滞麻醉与皮下浸润麻醉,有效减轻产妇在产时和产后的切口疼痛,为产妇创造一个良好的康复条件.
目的 比較囉哌卡因與利多卡因運用于會陰側切縫閤術中與術後的鎮痛效果.方法 選擇需行會陰側切術且無手術禁忌癥、無產科併髮癥、無精神疾患的產婦80例,隨機分為實驗組和對照組,每組各40例.實驗組運用0.375%囉哌卡因20 ml,對照組運用1%利多卡因20 ml,分彆在會陰側切前行陰部神經阻滯痳醉與皮下浸潤痳醉.觀察比較兩組產婦在術中與術後的疼痛程度、痳醉持續時間、新生兒Apgar's評分情況、有無產後尿潴留等不良反應.結果 實驗組在縫閤術中、用藥後1h、2 h、4h、8 h的疼痛VAS評分均低于對照組,F=6.01(P＜0.05),提示實驗組在會陰側切縫閤術的鎮痛效果與鎮痛持續時間明顯優于對照組.新生兒1分鐘、5分鐘的Apgar's評分兩組無差彆,t=1.863(P＞0.05).未髮現對產後齣血、尿潴留等不良反應的不良影響.結論 囉哌卡因具有鎮痛作用彊和持續時間長等優點,效果優于利多卡因.在會陰側切術中應用小劑量囉哌卡因行會陰部神經阻滯痳醉與皮下浸潤痳醉,有效減輕產婦在產時和產後的切口疼痛,為產婦創造一箇良好的康複條件.
목적 비교라고잡인여리다잡인운용우회음측절봉합술중여술후적진통효과.방법 선택수행회음측절술차무수술금기증、무산과병발증、무정신질환적산부80례,수궤분위실험조화대조조,매조각40례.실험조운용0.375%라고잡인20 ml,대조조운용1%리다잡인20 ml,분별재회음측절전행음부신경조체마취여피하침윤마취.관찰비교량조산부재술중여술후적동통정도、마취지속시간、신생인Apgar's평분정황、유무산후뇨저류등불량반응.결과 실험조재봉합술중、용약후1h、2 h、4h、8 h적동통VAS평분균저우대조조,F=6.01(P＜0.05),제시실험조재회음측절봉합술적진통효과여진통지속시간명현우우대조조.신생인1분종、5분종적Apgar's평분량조무차별,t=1.863(P＞0.05).미발현대산후출혈、뇨저류등불량반응적불량영향.결론 라고잡인구유진통작용강화지속시간장등우점,효과우우리다잡인.재회음측절술중응용소제량라고잡인행회음부신경조체마취여피하침윤마취,유효감경산부재산시화산후적절구동통,위산부창조일개량호적강복조건.
Objective To compare the analgesic effect of ropivacaine and lidocaine during and after lateral episiotomy perineorrhaphy. Methods 80 mental well pregnant women who needed to have the lateral episiotomy perineorrhaphy were selected as our participants, they were all without surgical contraindications and obstetric complications. Then they were randomly divided into 2 groups, the experimental and the control group, and each group consisted 40 participants. Before the episiotomy, the experimental group was applied with 0.375% ropivacaine 20ml, the control group was applied with 1% lidocaine 20ml respectively to achieve perineal nerve block anesthesia and subcutaneous infiltration anesthesia. In the study we not only compared the pain level and the analgesia time between the 2 groups and also evaluated the Apgar score, the postpartum urinary retention and other adverse reactions between them. Results The VAS score of the experimental group is lower than that in the control group during and after the analgesic was administrated 1 hour, 2 hours, 4 hours and 8 hours, F=6.01( P＜0.05 ). It reminds us that not only the analgesic effect but also the analgesia time of ropivacaine is better than the lidocaine, however, the Apgar's 1 minute's and 5 minute's score were non-significant between the 2 groups, t=1.863 ( P＞ 0.05 ), and the adverse effects such as Postpartum hemorrhage and Urinary retention were also non-significant between the 2 groups .Conclusion Compared with lidocaine, ropivacaine's analgesic effect is much stronger and it's analgesic time is much longer. When we apply the lateral episiotomy perineorrhaphy, we use low-dose ropivacaine instead of lidocaine to achieve the goal of perineal subcutaneous infiltration anesthesia and nerve block anesthesia, we can relieve the Incision pain during and after the operation effectively at the same time providing a better recovery premise for the pregnant women.
