右美托咪定联合罗哌卡因规律性间断硬膜外注射在分娩镇痛中的临床应用

doi:10.3969/j.issn.2095-9400.2020.09.012

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Abstract Objective: To discuss the clinical application effect of dexmedetomidine combined with ropivacaine for programmed intermittent epidural bolus (PIEB) in labor analgesia. Methods: Sixty primiparas admitted to the First Affiliated Hospital of Wenzhou Medical University from Sep 2018 to August 2019 were randomly divided into two groups: fentanyl group (Fen group, n=30) received epidural 2 μg/mL fentanyl and 0.1% ropivacaine, whereas the other dexmedetomidine group (Dex group, n=30) received epidural 0.5 μg/mL dexmedetomidine and 0.1% ropivacaine. Both groups were given epidural analgesic solution of 8 mL every 60 minutes respectively. The heart rate (HR), fetal heart rate (FHR), and mean arterial pressure (MAP) were assessed at the beginning of analgesia (T0), 15 min (T1), 30 min (T2), 1 h (T3), 2 h (T4) after analgesia, beginning of the second stage (T5), and 1 h after delivery (T6). Pain visual analogue scale (VAS), Ramsay sedation score, and modified Bromage score were assessed. And the neonatal Apgar score of 5 min, anesthetics consumptions, first and second stage, side effects, and PCEA attempts numbers were also observed. Results: The HR, FHR, MAP, modified Bromage score, the first and second stage, and neonatal Apgar score of 5 min did not show significant difference between 2 groups (P>0.05). Compared with Fen group, The VAS of Dex group were extremely declined and the Ramsay sedation score were significantly increased at T1 and T2 (P<0.05). The anesthetics consumptions and PCEA attempts numbers of Dex group were definitely lower than Fen group (P<0.05). The side effect did not show significant difference between 2 groups (P>0.05). Conclusion: The dexmedetomidine combined with ropivacaine for pieb in labor analgesia reduces local anesthetics consumption and pain outbreak, and has better analgesic and sedative effect.

Key words： dexmedetomidine ropivacaine analgesia, obstetrical programmed intermittent epidural bolus

Received: 08 March 2020

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	YU Chenchen
	LIU Xuejiao
	CAI Xixi
	LIU Jianlong
	ZHU Na.

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https://xb.wmu.edu.cn/EN/10.3969/j.issn.2095-9400.2020.09.012 OR https://xb.wmu.edu.cn/EN/Y2020/V50/I9/748

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