摘要
Abstract
Objective: To investigate the analgesic efficacy and safety of patient controlled intravenous analgesia ( PCIA ) with dezocin and infused dexmedetomidine for labor analgesia. Method: Ninty ASA Ⅰ-Ⅱfull term primigravidae in active labor who had a single fetus with vertex presentation and were expected to have a vaginal delivery were randomly divided into 3 groups: I control group ( n: 30 ) received no analgesia;group A ( n = 30 ) and group B ( n = 30 ) received analgesia. In group A the loading dose of dezocin ( 0. 15mg/kg) and dexmedetomidine ( 1 ug/kg ) were infused , infused dexmedetomidine ( 0.4ug/kg. h ) and PCIA with O. 05％ dezocin( background infusion 4mL/h ,demand bolus 2mL with a 15 min lockout interval and a total dose limit of 60mg ); In group B, a catheter was advanced 4cm into epidural space cephalad at L2-3.lOmL 0.125％ ropivacaine with fentanyl 1.5 ug/mL was infused into epidural space cephalad, and PCEA with 0.125％ ropivacaine with fentanyl 1.5 ug/mL( background infusion 4mL/h ,demand bolus 4mL with a 15 min lockout interval). The intensity of pain was evaluated by patients using VAS. The vital signs ( BP, HR,SPO2 ) ,fetal heart rate,labor process, mode of delivery, Apg()re of neonates and side effects of analgesia were recorded. Result: Good analgesia was achieved with high patient satisfaction in group A( 94.8％ ) and B (95.6％ ) as compared with control group, but there was no significant difference in VAS score between group A and B. there was no significant difference in Apar score among the 3 groups. The duration of second stage of labor was longer in group B than that in group A and control group ( P＜0.05 ). The rate of cesarean section was significantly in control group than that in group A and B,but the difference between group A and B was not statistically significant. There was no significant difference in vital signs, fetal heart rate and uterine contraction among the 3 group. Conclusion: PCIA with ropivacaine dezocin and infused dexmedetomidine is safe and effective for labor analgesia.关键词
地佐辛/右美托咪定/分娩镇痛/病人自控静脉镇痛Key words
Dezocin/ Dexmedetomidine/ Labor analgesia/ PCIA
