Page 70 - 《中国药房》2024年14期

·药物与临床·

0.2%氯普鲁卡因联合罗哌卡因对硬膜外分娩镇痛效果及对罗哌

卡因EC 的影响
Δ
50
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黄学桂 ，吴晓萱 ，陈 冉 ，朱海娟 （1.安徽省妇女儿童医学中心/合肥市妇幼保健院药学部，合肥 230001；
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2.安徽省妇女儿童医学中心/合肥市妇幼保健院麻醉科，合肥 230001）
中图分类号 R969.4 文献标志码 A 文章编号 1001-0408（2024）14-1732-05
DOI 10.6039/j.issn.1001-0408.2024.14.10

摘 要 目的 探讨0.2%氯普鲁卡因联合罗哌卡因对硬膜外分娩镇痛效果及对罗哌卡因半数有效浓度（EC50 ）的影响。方法 选择
2023年7月至10月在我院行阴道分娩且有镇痛需求的产妇67例，按随机数字表法分为RL组（33例）和R组（34例）。采用Dixon
改良序贯法确定罗哌卡因的浓度。RL组产妇给予0.2%盐酸氯普鲁卡因注射液+盐酸罗哌卡因注射液+0.4 μg/mL枸橼酸舒芬太
尼注射液；R 组产妇给予盐酸罗哌卡因注射液+0.4 μg/mL 枸橼酸舒芬太尼注射液。观察两组产妇的罗哌卡因 EC50、分娩镇痛效
果、镇痛药总用量、镇痛满意度评分、不良反应发生情况、分娩情况及新生儿Apgar评分。结果 RL组产妇的罗哌卡因EC50、镇痛起
效时间、补救镇痛率、会阴胀痛和爆发痛发生率、镇痛药总用量均显著低于R组，镇痛满意度评分显著高于R组（P＜0.05）；两组产
妇的下肢麻木、下肢无力、寒战等不良反应发生率，产程时间、出血量、分娩方式及新生儿 Apgar 评分比较，差异均无统计学意义
（P＞0.05）。结论 0.2% 氯普鲁卡因联合罗哌卡因用于硬膜外分娩镇痛，可降低罗哌卡因的 EC50，改善分娩镇痛效果，且安全性
较好。
关键词 罗哌卡因；氯普鲁卡因；硬膜外；分娩镇痛；半数有效浓度

Effects of 0.2% chloroprocaine combined with ropivacaine on epidural labor analgesia and EC50 of
ropivacaine
HUANG Xuegui ，WU Xiaoxuan ，CHEN Ran ，ZHU Haijuan （1. Dept. of Pharmacy， Anhui Women and
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Children’s Medical Center/Hefei Maternal and Child Health Hospital， Hefei 230001， China；2. Dept. of
Anesthesiology， Anhui Women and Children’s Medical Center/Hefei Maternal and Child Health Hospital， Hefei
230001， China）
ABSTRACT OBJECTIVE To investigate the effects of 0.2% chloroprocaine combined with ropivacaine on epidural labor
analgesia and median effective concentration （EC50 ） of ropivacaine. METHODS Totally 67 parturients who scheduled for vaginal
delivery and required epidural labor analgesia were collected from our hospital from July to October 2023 and randomly divided
into RL group （33 cases） and R group （34 cases）. The concentration of ropivacaine was determined by modified Dixon sequential
method. RL group was given 0.2% Chloroprocaine hydrochloride injection+Ropivacaine hydrochloride injection+0.4 μg/mL
Sufentanil citrate injection； R group was given Ropivacaine hydrochloride injection+0.4 μg/mL Sufentanil citrate injection. EC50 of
ropivacaine， analgesic effect during delivery， total dosage of analgesic drugs， analgesic satisfaction score， the incidence of adverse
reactions， delivery status， and Apgar score of newborns were observed in two groups. RESULTS EC50 of ropivacaine， onset time，
remedial analgesia rate， the incidence of perineal distension and breakthrough pain and total dosage of analgesic drugs of RL group
were significantly lower than R group， and analgesic satisfaction score was significantly higher than R group （P＜0.05）. There was
no statistical significance in the incidence of adverse reactions such as numbness， weakness， and chills in the lower limbs， or the
duration of labor， amount of bleeding， mode of delivery， and Apgar score of newborns between 2 groups （P＞0.05）.
CONCLUSIONS For epidural labor analgesia， 0.2%
Δ 基金项目 国家自然科学基金项目（No.82100315）；合肥市医学
chloroprocaine combined with ropivacaine can reduce EC50 of
重点专科建设项目（No.合卫医秘〔2023〕72号）
＊第一作者 副主任药师，硕士。研究方向：临床药学。E-mail： ropivacaine， improve analgesia effect and have good safety.
370889744@qq.com KEYWORDS ropivacaine； chloroprocaine； epidural； labor
# 通信作者 主任医师，硕士。研究方向：妇产科麻醉与镇痛。 analgesia； median effective concentration
E-mail：35880762@qq.com

· 1732 · China Pharmacy 2024 Vol. 35 No. 14 中国药房 2024年第35卷第14期