中华生物医学工程杂志
中華生物醫學工程雜誌
중화생물의학공정잡지
CHINESE JOURNAL OF BIOMEDICAL ENGINEERING
2012年
1期
63-66
,共4页
付卫星%康佳丽%李莉%潘时妹
付衛星%康佳麗%李莉%潘時妹
부위성%강가려%리리%반시매
舒芬太尼%罗哌卡因%麻醉,硬膜外%蛛网膜下腔麻醉%镇痛%分娩%婴儿,新生
舒芬太尼%囉哌卡因%痳醉,硬膜外%蛛網膜下腔痳醉%鎮痛%分娩%嬰兒,新生
서분태니%라고잡인%마취,경막외%주망막하강마취%진통%분면%영인,신생
Sufentanil%Ropivacaine%Anesthesia,epidural%Subarachnoid anaesthesia%Analgesia%Parturition%Infant,newborn
目的 观察舒芬太尼复合罗哌卡因蛛网膜下腔和硬膜外联合麻醉分娩镇痛对新生儿的影响.方法 选择产科无椎管内麻醉及无阴道试产禁忌证的足月单胎头位初产妇100例,随机分为两组.Ⅰ组(n=50)产妇给予0.5 mg/L舒芬太尼联合0.1％罗哌卡因,蛛网膜下腔麻醉单次用药1.5 ml,硬膜外自控镇痛持续剂量5 ml/h,锁定时间15 min.Ⅱ组(n=50)产妇给予0.1％罗哌卡因,蛛网膜下腔麻醉单次用药1.5 ml,硬膜外自控镇痛持续剂量5 ml/h,锁定时间15 min.观察分娩镇痛效果,于分娩镇痛开始后10(T1)、30(T2)、60 min(T3)及120 min(T4)记录产妇镇痛评分(VAS评分),记录镇痛泵的进药容量、总按压次数(D1)/实际有效进药次数(D2)值.两组新生儿出生后即行血气分析,记录新生儿阿氏评分(Apgar),新生儿出生后连续5d进行新生儿神经行为评分(NBNA)及测定新生儿黄疸指数、体质量及血糖.结果 两组产妇T1～T4时点VAS评分的差异无统计学意义.D1/D2比值在T1、T2时点差异无统计学意义,而在T3、T4时点Ⅱ组高于Ⅰ组(2.5±1.0比1.5±0.9,2.8±1.2比2.1±0.6,均P＜0.05).镇痛泵的进药总量Ⅱ组也高于Ⅰ组[ (21.2±3.1) ml比(12±4.5) ml,P＜0.05].两组新生儿出生后5d内的NBNA、黄疸指数、生理性体质量下降幅度及血糖之间差异均无统计学意义.结论 0.5 mg/L舒芬太尼联合0.1％罗哌卡因蛛网膜下腔和硬膜外联合麻醉分娩镇痛可提供良好的镇痛效果,对新生儿具有良好的安全性.
目的 觀察舒芬太尼複閤囉哌卡因蛛網膜下腔和硬膜外聯閤痳醉分娩鎮痛對新生兒的影響.方法 選擇產科無椎管內痳醉及無陰道試產禁忌證的足月單胎頭位初產婦100例,隨機分為兩組.Ⅰ組(n=50)產婦給予0.5 mg/L舒芬太尼聯閤0.1％囉哌卡因,蛛網膜下腔痳醉單次用藥1.5 ml,硬膜外自控鎮痛持續劑量5 ml/h,鎖定時間15 min.Ⅱ組(n=50)產婦給予0.1％囉哌卡因,蛛網膜下腔痳醉單次用藥1.5 ml,硬膜外自控鎮痛持續劑量5 ml/h,鎖定時間15 min.觀察分娩鎮痛效果,于分娩鎮痛開始後10(T1)、30(T2)、60 min(T3)及120 min(T4)記錄產婦鎮痛評分(VAS評分),記錄鎮痛泵的進藥容量、總按壓次數(D1)/實際有效進藥次數(D2)值.兩組新生兒齣生後即行血氣分析,記錄新生兒阿氏評分(Apgar),新生兒齣生後連續5d進行新生兒神經行為評分(NBNA)及測定新生兒黃疸指數、體質量及血糖.結果 兩組產婦T1～T4時點VAS評分的差異無統計學意義.D1/D2比值在T1、T2時點差異無統計學意義,而在T3、T4時點Ⅱ組高于Ⅰ組(2.5±1.0比1.5±0.9,2.8±1.2比2.1±0.6,均P＜0.05).鎮痛泵的進藥總量Ⅱ組也高于Ⅰ組[ (21.2±3.1) ml比(12±4.5) ml,P＜0.05].兩組新生兒齣生後5d內的NBNA、黃疸指數、生理性體質量下降幅度及血糖之間差異均無統計學意義.結論 0.5 mg/L舒芬太尼聯閤0.1％囉哌卡因蛛網膜下腔和硬膜外聯閤痳醉分娩鎮痛可提供良好的鎮痛效果,對新生兒具有良好的安全性.
목적 관찰서분태니복합라고잡인주망막하강화경막외연합마취분면진통대신생인적영향.방법 선택산과무추관내마취급무음도시산금기증적족월단태두위초산부100례,수궤분위량조.Ⅰ조(n=50)산부급여0.5 mg/L서분태니연합0.1％라고잡인,주망막하강마취단차용약1.5 ml,경막외자공진통지속제량5 ml/h,쇄정시간15 min.Ⅱ조(n=50)산부급여0.1％라고잡인,주망막하강마취단차용약1.5 ml,경막외자공진통지속제량5 ml/h,쇄정시간15 min.관찰분면진통효과,우분면진통개시후10(T1)、30(T2)、60 min(T3)급120 min(T4)기록산부진통평분(VAS평분),기록진통빙적진약용량、총안압차수(D1)/실제유효진약차수(D2)치.량조신생인출생후즉행혈기분석,기록신생인아씨평분(Apgar),신생인출생후련속5d진행신생인신경행위평분(NBNA)급측정신생인황달지수、체질량급혈당.결과 량조산부T1～T4시점VAS평분적차이무통계학의의.D1/D2비치재T1、T2시점차이무통계학의의,이재T3、T4시점Ⅱ조고우Ⅰ조(2.5±1.0비1.5±0.9,2.8±1.2비2.1±0.6,균P＜0.05).진통빙적진약총량Ⅱ조야고우Ⅰ조[ (21.2±3.1) ml비(12±4.5) ml,P＜0.05].량조신생인출생후5d내적NBNA、황달지수、생이성체질량하강폭도급혈당지간차이균무통계학의의.결론 0.5 mg/L서분태니연합0.1％라고잡인주망막하강화경막외연합마취분면진통가제공량호적진통효과,대신생인구유량호적안전성.
Objective To investigate the effects of combined subarachnoid and epidural analgesia (CSEA) using sufentanil plus ropivacaine on neonates.Methods A total of 100 full term primiparae with singleton and cephalic presentation and without contraindications for intraspinal anesthesia or vaginal delivery were selected and randomly divided into two groups.Group Ⅰ (n=50) was given a mixture of 0.5mg/L sufentanil and 0.1％ ropivacaine for 1.5 ml single-dose subarachnoid anesthesia and 15 min 5 ml/h patient-controlled epidural analgesia; group Ⅱ (n=50) was given 0.1％ ropivacaine for 1.5 ml single-dose subarachnoid anesthesia and 15 min 5 ml/h patient-controlled epidural analgesia.The analgesic effects were then observed,and VAS scoring was recorded at 10 (T1),30(T2),60(T3)and 120 min(T4),as well as the drug volume in analgesia pump,the number of total press (D1)/number of practical and effective drug (D2).The blood gas analysis was immediately performed after the birth of neonates in two groups,and the Apgar score was recorded.The neurological assessment (NBNA),neonatal jaundice index,weight and blood sugar were determined in 5 consecutive days after birth of the neonates.Results There were no significant differences in VAS scoring during T1 to T4 between two groups of puerperas.The two groups showed no difference in D1/D2 ratio at T1 and T2,but group Ⅱ had a higher D1/D2 ratio than group Ⅰ at T3 and T4 (2.5±1.0 vs 1.5±0.9,2.8±1.2 vs 2.1±0.6,all P＜0.05).The total drug volume in analgesia pump in group Ⅱ was also higher than that in group Ⅰ [ (21.2±3.1)ml vs (12±4.5) ml,P＜0.05].No significant difference was found in NBNA,neonatal jaundice index,the decreased weight and blood sugar between the two groups of neonates within 5 d after birth.Conclusion CSEA using 0.5 mg/L sufentanil plus 0.1％ ropivacaine can provide the favorable analgesia efficacy for puerperas and safety for the neonates.
