RESUMO
Objective To observe and compare the efficacy and safety of chloroprocaine and ropivacaine for epidural labor analgesia.Methods 86 cases of voluntary acceptance of maternal painless natural childbirth were selected in the study.43 cases were given chloroprocaine epidural analgesia (chloroprocaine group),and the other 43 cases were given ropivacaine epidural analgesia (ropivacaine group).The pain (VAS score),lower limb motor block degree(MBS score),fetal heart rate(FHR) and contractions duration of maternal prenatal and medication immediately after 10min,20min,40min,80min were compared between two groups.The first,second and third stage of labor and fetal output after 1 min,5min,10min Apgar score were compared.The incidence of adverse events were observed.Results In the chloroprocaine group,the 10min VAS score was (2.10 ± 1.02),which was significantly lower than (4.31 ± 1.13) in the ropivacaine group (t =4.565,P ＜ 0.05).In the chloroprocaine group,analgesia 20min MBS score was (0.24 ± 0.03),which was significantly higher than (0.11 ± 0.04) in the ropivacaine group (t =4.126,P ＜ 0.05).In the chloroprocaine group,4 cases occurred nerve injury,which was more than the ropivacaine group (1 case),the difference was statistically significant (x2 =4.263,P ＜ 0.05).Conclusion Chloroprocaine and ropivacaine for epidural labor analgesia have superior efficacy and the clinical efficacy is similar.Chloroprocaine has the advantage of quick results,but the medication about 20min time period that the drug might lead to a greater degree of lower limb motor block,and has the risk of nerve injury,pregnant women can choose according to their medication.
RESUMO
Objective To study the effect and safety of spinal-epidural anesthesia(CSEA) and epidural anesthesia(EA) in the surgery of the elderly patients over age of 75.Methods 96 elderly patients over the age of 75 with lower limb surgery and the ASA Ⅱ ～ Ⅲ grade were randomly divided into two groups according to the anesthesia method.The study group(48 cases) was treated with CSEA and the control group(48 cases) was given EA.The heart rate (HR),systolic blood pressure (SBP),diastolic blood pressure (DBP),oxygen saturation (SpO2) before anesthesia (T0),after anesthesia(T1),after the beginning of surgery(T2) and the end of the surgery(T3) were recorded.And the onset time,block perfect time,anesthetic effect and adverse reaction were observed.Results The HR,SBP,DBP,and SpO2 between the two groups and within the two groups had no statistically significant differences (P ＞ 0.05) ;the onset time and complete block time of anesthesia of the study group were significantly shorter than the control group (P ＜ 0.05),the anesthetic effect of the study group was significantly better than the control group (P ＜ 0.05).The incidence rate of adverse reactions had no statistically significant difference between the two groups (P ＞ 0.05).Conclusion CSEA has rapid onset of anesthetic and the anesthetic effect is good,it has few adverse reactions for elderly patients with lower limb surgery,and it is safe and effective,which is worth to be promoted and popularized in clinical.