So sánh tác dụng không mong muốn của gây tê ngoài màng cứng bằng hỗn hợp ropivacain - fentanyl với bupivacain - fentanyl để giảm đau trong chuyển dạ đẻ

Abstract

Objective: To compare the effect on maternal cardiovascular, maternal respiration and other side effects on mothers and newborn of ropivacaine 0.1% + fentanyl 2 mcg/ml versus bupivacaine 0.1% + fentanyl 2mcg/ml in pain relief during the labor by epidural anesthesia. Subject and method:  The study was conducted on 60 pregnant women, labor delivered at the National Obstetrics and Gynecology Hospital, from March 2013 to September 2013 and was given analgesic by epidural anesthesia and randomly assigned to two groups. The RF group used 0.1% ropivacaine + fentanyl 2mcg/mL. The BF group used 0.1% bupivacaine + 2mcg/ml fentanyl. Anesthetics will be injected intermittently between doses of 5 - 7ml, spaced 5 minutes into the epidural catheter when starting and when the pain come back (VAS > 4). Result: There were no statistically significant differences in maternal cardiovascular and respiratory effects between the two groups (heart rate, mean arterial pressure, respiratory rate, SpO2 of two groups at all times of labor delivery). The side effects of ropivacaine 0.1% did not differ significantly from those of bupivacaine 0.1% (4% versus 8,7% for backache; 8% vs 4.3% for nausea; 12% vs 8.7% for pruris; 8% vs 13% for shivering, 8% vs 21.7% for motor bloc with Bromage I. Conclusion: Epidural epidural analgesia with 0.1% ropivacaine + 2mcg/ml fentanyl had little effect on maternal cardiovascular and respiratory, side effects on mothers and newborn were equivalent to epidural anesthesia with bupivacaine 0.1% + fentanyl 2mcg/ml but less motor bloc.