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硬膜外右美托咪定联合罗哌卡因用于分娩镇痛的效果:一项随机双盲对照研究。

Effect of Epidural Dexmedetomidine Combined With Ropivacaine in Labor Analgesia: A Randomized Double-Blinded Controlled Study.

作者信息

Zhao Yang, Xin Yan, Liu Yongbo, Yi Xuanlong, Liu Yingzhi

机构信息

*Department of Anesthesiology ‡The Affiliated Hospital of Qingdao University †Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao, China.

出版信息

Clin J Pain. 2017 Apr;33(4):319-324. doi: 10.1097/AJP.0000000000000411.

Abstract

BACKGROUND

The purpose of our study is to evaluate the effect of adding dexmedetomidine to epidural ropivacaine in patients undergoing labor epidural analgesia.

METHODS

Eighty healthy women were randomly assigned to 2 groups: control group (R; n=40) received epidural 0.125% ropivacaine for labor analgesia, whereas the study group (D; n=40) received epidural 0.125% ropivacaine with dexmedetomidine in addition. The blood pressure, heart rate, and the severity of pain of the parturient was assessed, the duration of the first stage and the second stage of labor time, the rate of instrumental delivery and the rate of cesarean section were recorded. The side effects (nausea and vomiting), intensity of maternal sedation, and neonatal Apgar scores were also recorded.

RESULTS

The visual analog scales, systolic blood pressure, diastolic blood pressure, and heart rates of D group were significant lower than that of R group at most time intervals after epidural analgesia. The duration of the first and second stage of labor, the rate of instrumental delivery and cesarean section, neonatal 1- and 5-minute Apgar scores, umbilical artery pH, maternal motor blockade scores, intensity of maternal sedation, and the incidence of maternal complications did not show significant difference between 2 groups.

CONCLUSIONS

Low concentration of epidural ropivacaine (0.125%) combined with dexmedetomidine (0.5 μg/kg) reduces the feeling of pain, and does not show the problems of motor blockage, hemodynamic instability, extension of production process, and complications such as nausea and vomiting. Our study was registered with Chinese Clinical Trial Registry (ChiCTR-IOR-15007263).

摘要

背景

我们研究的目的是评估在分娩硬膜外镇痛的患者中,在硬膜外罗哌卡因中添加右美托咪定的效果。

方法

80名健康女性被随机分为两组:对照组(R组;n = 40)接受硬膜外0.125%罗哌卡因用于分娩镇痛,而研究组(D组;n = 40)除接受硬膜外0.125%罗哌卡因外还加用右美托咪定。评估产妇的血压、心率和疼痛程度,记录第一产程和第二产程的时间、器械助产率和剖宫产率。还记录副作用(恶心和呕吐)、产妇镇静程度和新生儿Apgar评分。

结果

硬膜外镇痛后大多数时间间隔,D组的视觉模拟评分、收缩压、舒张压和心率均显著低于R组。两组在第一产程和第二产程的时间、器械助产率和剖宫产率、新生儿1分钟和5分钟Apgar评分、脐动脉pH值、产妇运动阻滞评分、产妇镇静程度以及产妇并发症发生率方面均未显示出显著差异。

结论

低浓度硬膜外罗哌卡因(0.125%)联合右美托咪定(0.5μg/kg)可减轻疼痛感觉,且未出现运动阻滞、血流动力学不稳定、产程延长以及恶心和呕吐等并发症问题。我们的研究已在中国临床试验注册中心注册(ChiCTR-IOR-15007263)。

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