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| Minimum local analgesic concentration of Ropivacaine combined with Hydromorphone for epidural labor analgesia during incubation period using sequential allocation method#br# |
| WANG Kegong WANG Haijin ZHANG Zhen LUO Huiyu |
| Department of Anesthesiology, Xiangyang NO.1 People’s Hospital, Affiliated Hospital of Hubei University of Medicine, Hubei Province, Xiangyang 441000, China |
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Abstract Objective To determine the minimum local analgesic concentration (MLAC) and 90% effective concentration (EC90) of Ropivacaine combined with Hydromorphone for epidural labor analgesia during latent period. Methods Thirty cases of singleton primiparous admitted to Xiangyang NO.1 People’s Hospital, Affiliated Hospital of Hubei University of Medicine from June 2019 to January 2020 were selected as study objects. All parturients entered the incubation period of the first stage of labor, L2-3 was selected for epidural labor analgesia, and 10 ml of Ropivacaine mixed with 15 μg/ml Hydromorphone was given. According to the modified sequential allocation method to increase or decrease the concentration of Ropivacaine, the initial concentration was 0.07%, the concentration gradient was 0.01%. Visual analogue scale (VAS) was used to evaluate the analgesia effect. If VAS score ≤3 points, the next patient was reduced a concentration gradient; if VAS score >3 points, after giving 6 ml of dose 0.1% Ropivacaine mixed with 0.5 μg/ml Sufentanil to remedy and VAS score≤3 points, the following one patient was increased a concentration gradient; if after giving remedy drugs and VAS score >3 points, this case was eliminated, and the next patient was repeated this concentration. VAS score during contractions were recorded before injection, 5, 15, and 30 min after injection. MLAC and EC90 of Ropivacaine were calculated by probability unit regression analysis. Results MLAC of Ropivacaine combined with Hydromorphone for epidural labor analgesia in incubation period was 0.035%, and EC90 was 0.049%. Conclusion MLAC of Ropivacaine combined with Hydromorphone for epidural labor analgesia in incubation period is 0.035%, and EC90 is 0.049%, it can be safely used for epidural labor analgesia with fast analgesic effect and few adverse reactions.
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