右美托咪定联合罗哌卡因硬膜外自控镇痛在足月妊娠产妇分娩中临床研究.docVIP

右美托咪定联合罗哌卡因硬膜外自控镇痛在足月妊娠产妇分娩中临床研究 　　[摘要] 目的 研究右美托咪定?合罗哌卡因硬膜外自控镇痛在足月妊娠产妇分娩中的临床应用效果。 方法 选取2015年5月～2016年5月入住我院分娩的足月妊娠产妇，共200例，按照自愿、随机原则分为试验组100例和对照组100例，试验组产妇在分娩过程中硬膜外镇痛使用5 mL右美托咪定（0.5 μg/kg）和10 mL 0.1%罗哌卡因，对照组产妇在分娩过程中硬膜外镇痛使用5 mL芬太尼（1 g/kg）和10 mL 0.1%罗哌卡因。测量和记录两组产妇硬膜外分娩镇痛前（T0）、分娩镇痛后30 min（T1）、胎儿娩出时（T2）和胎儿娩出后10 min（T3）时刻的血压、心率和疼痛视觉模拟（VAS）评分，分娩镇痛前（T0）、分娩镇痛后30 min（T1）时刻的Ramsay镇静评分和胎心率并进行统计分析。结果 两组产妇硬膜外分娩镇痛前（T0）、分娩镇痛后30 min（T1）、胎儿娩出时（T2）和胎儿娩出后10 min（T3）时刻的血压、心率和分娩前的胎心率组间比较差异无统计学意义（P0.05）；两组产妇硬膜外分娩镇痛前（T0）的疼痛视觉模拟评分、Ramsay镇静评分比较差异无统计学意义（P0.05），分娩镇痛后30 min（T1）时刻试验组VAS评分低于对照组，Ramsay镇静评分高于对照组，差异均有统计学意义（P均0.05）。 结论 右美托咪定联合罗哌卡因硬膜外自控镇痛应用在足月妊娠产妇分娩中比芬太尼联合罗哌卡因具有更优的临床效果。 　　[关键词] 右美托咪定；罗哌卡因；硬膜外自控镇痛；足月妊娠 　　[中图分类号] R614；R714.3 [文献标识码] B [文章编号] 1673-9701（2017）26-0112-04 　　Clinical study of dexmedetomidine combined with ropivacaine for patient-controlled epidural analgesia in the delivery of full-term puerpera 　　LAN Lixia1 PING Yongmei1 LI Zhonghua2 　　1.Department of Anesthesiology， Lishui Women and Childrens Hospital in Zhejiang Province， Lishui 323000， China； 2.Department of Anesthesiology， Lishui Peoples Hospital in Zhejiang Province， Lishui 323000， China 　　[Abstract] Objective To study the clinical application effect of dexmedetomidine combined with ropivacaine for patient-controlled epidural analgesia in the delivery of full-term puerpera. Methods A total of 200 full-term puerpera who were admitted to our hospital from May 2015 to May 2016 were selected. According to the voluntary and random principle， the patients were divided into the experimental group of 100 cases and the control group of 100 cases. The puerpera in the experimental group were given epidural analgesia in the course of delivery using 5 ml dexmedetomidine （0.5 μg/kg） and 10 ml 0.1% ropivacaine. The puerpera in the control group was given epidural analgesia during the course of delivery using 5 ml fentanyl （1 g/kg） and 10 ml 0.1% ropivacaine. The blood pressure， heart rate and VAS scores were measured and record