背景:据报道,3%氯普鲁卡因(CP)是分娩镇痛期间紧急剖宫产的孕妇常用的局部麻醉药。然而,0.75%罗哌卡因被认为是一种有前途和有效的替代品。因此,我们进行了一项随机对照试验,比较了0.75%罗哌卡因和3%氯普鲁卡因用于孕妇延长硬膜外麻醉的有效性和安全性.
方法:我们进行了双盲,随机化,控制,单中心研究从2022年11月1日至2023年4月30日。我们选择了45名在分娩镇痛期间接受紧急剖宫产的孕妇,并随机分配他们以1:1的比例接受0.75%的罗哌卡因或3%的氯普鲁卡因。主要结果是在T4水平时丧失冷感的时间。
结果:两组之间在达到冷感丧失的时间上存在显着差异(303,95CI255至402S与372,95CI297至630S,p=0.024)。Th4水平的运动阻滞程度无显著差异(p=0.185)。与氯普鲁卡因组相比,罗哌卡因组需要额外局部麻醉药的孕妇较少(4.5%VS。34.8%,p=0.011)。与氯普鲁卡因组相比,罗哌卡因组的术中VAS评分较低(p=0.023),患者满意度评分较高(p=0.040)。两组术中并发症发生率相似,无严重并发症发生。
结论:我们的研究发现,0.75%罗哌卡因与术中疼痛治疗有关,在分娩镇痛期间接受紧急剖宫产的孕妇中,与3%氯普鲁卡因相比,患者满意度更高,起效时间缩短。因此,0.75%罗哌卡因可能是分娩镇痛期间紧急剖宫产孕妇的合适药物。
背景:注册号:ChiCTR2200065201;http://www。chictr.org.cn,首席调查员:男人,注册日期:2022-10-31.
BACKGROUND: 3% chloroprocaine (CP) has been reported as the common local anesthetic used in pregnant women undergoing urgent cesarean delivery during labor analgesia period. However, 0.75%
ropivacaine is considered a promising and effective alternative. Therefore, we conducted a randomized controlled trial to compare the effectiveness and safety of 0.75%
ropivacaine with 3% chloroprocaine for extended epidural anesthesia in pregnant women.
METHODS: We conducted a double-blind, randomized, controlled, single-center study from November 1, 2022, to April 30, 2023. We selected forty-five pregnant women undergoing urgent cesarean delivery during labor analgesia period and randomized them to receive either 0.75% ropivacaine or 3% chloroprocaine in a 1:1 ratio. The primary outcome was the time to loss of cold sensation at the T4 level.
RESULTS: There was a significant difference between the two groups in the time to achieve loss of cold sensation (303, 95%CI 255 to 402 S vs. 372, 95%CI 297 to 630 S, p = 0.024). There was no significant difference the degree of motor block (p = 0.185) at the Th4 level. Fewer pregnant women required additional local anesthetics in the ropivacaine group compared to the chloroprocaine group (4.5% VS. 34.8%, p = 0.011). The
ropivacaine group had lower intraoperative VAS scores (p = 0.023) and higher patient satisfaction scores (p = 0.040) than the chloroprocaine group. The incidence of intraoperative complications was similar between the two groups, and no serious complications were observed.
CONCLUSIONS: Our study found that 0.75%
ropivacaine was associated with less intraoperative pain treatment, higher patient satisfaction and reduced the onset time compared to 3% chloroprocaine in pregnant women undergoing urgent cesarean delivery during labor analgesia period. Therefore, 0.75%
ropivacaine may be a suitable drug in pregnant women undergoing urgent cesarean delivery during labor analgesia period.
BACKGROUND: The registration number: ChiCTR2200065201; http://www.chictr.org.cn , Principal investigator: MEN, Date of registration: 31/10/2022.