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Anesthesiology:硬膜外药物输注速率对分娩镇痛效果的影响:随机临床试验

2018-02-04 王贵龙 “罂粟花”微信号

研究表明,硬膜外分娩镇痛时局部麻醉药间断使用比持续输注有更好的镇痛效果,且硬膜外高速输注增加导管处的输送压力,并可改善硬膜外腔中的药物分布。本研究假设高速硬膜外输注可改善硬膜外分娩镇痛效果及药物使用量。

背景与目的:研究表明,硬膜外分娩镇痛时局部麻醉药间断使用比持续输注有更好的镇痛效果,且硬膜外高速输注增加导管处的输送压力,并可改善硬膜外腔中的药物分布。本研究假设高速硬膜外输注可改善硬膜外分娩镇痛效果及药物使用量。

方  法:本研究为双盲、随机、对照试验,试验对象均为首次妊娠且宫口扩张≤5cm并要求性硬膜外镇痛的产妇;硬外膜导管置入后,芬太尼25ug推注;硬膜外维持药物及浓度分别为0.625mg/ml的布比卡因及0.625ug/ml的芬太尼,高速率组为300ml/h,低速率组为100 ml/h,病人自控镇痛剂量为5ml/次,锁定时间10min;主要结果为要求额外增加镇痛药物产妇的百分比。

结  果:高速率组共102名产妇,其中37人要求额外增加镇痛药物,百分比为36.3%,而低速率组共108名产妇,其中44人要求额外增加镇痛药物,百分比为40.7%(95%CI:-18.5~9.1%;P=0.67);两组间每小时布比卡因使用量及镇痛药物额外用量无明显差异,所有产妇均无其他不良反应发生。

结  论:硬膜外输注速率的高低并不会影响硬膜外镇痛效果及药物使用剂量。

原始出处:

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    2018-09-22 xiangyuzhou971
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    2018-02-06 zhaojie88
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    2018-02-06 zhaojie88
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    2018-02-06 skhzy
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    2018-02-04 131****1460

    学习了受益匪浅

    0

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