So sánh các tác dụng không mong muốn trên mẹ và con của giảm đau trong chuyển dạ bằng gây tê ngoài màng cứng do sản phụ tự điều khiển với ropivacain ở các nồng độ khác nhau phối hợp với fentanyl

Abstract

Objective: To compare the side effects on labor of patient controlled epidural analgesia (PCEA) with ropivacaine at concentrations of 0.075%; 0.1% and 0.125% combined with fentanyl 2mcg/ml. Subject and method: A randomized clinical trial comparing 90 women who received PCEA, divided into three groups, using ropivacaine concentration of 0.075%; 0.1% and 0.125% combined with fentanyl 2mcg/ml. Result: There was no statistically significant difference in the duration of labor, intensity, frequency of uterine contractions, fetal heart rate and Apgar score of neonatal among the three groups. All three concentrations did not affect the circulation, respiration and contractions of the uterus, fetal and neonatal status. The 0.125% ropivacaine group reduced the feeling of pulsation: 26.7% was normal (compared with 10% for the other two groups); reduced the ability of pulsation: 40% was normal (compared to 6.7% for the other two groups); motor block of Bromage grade 1 was 16.7% (compared to 0% in ropivacaine 0.075% and 3.3% in ropivacaine 0.1%). No cases of hypotension > 20%, pulse rate < 60/min, SpO₂ < 90% or nausea, headache in all three study groups. Some other side effects: Itching, back pain, chills, urinary retention... were low and there was no statistically significant difference in three groups. Conclusion: Pain relief in labor with PCEA with ropivacaine at concentrations of 0.075%; 0.1% and 0.125% in combination with fentanyl 2mcg/ml, there was no difference in uterine contractions, fetal heart rate and neonatal Apgar score and other side effects such as itching, back pain, chills, urinary retention... However, ropivacaine 0.125% group reduced the feeling of pulsation and the ability pulsation, increasing the rate of lower limb movement compared to the other two groups (p<0.05).