罗哌卡因联合舒芬太尼用于分娩镇痛的疗效观察

目的 研究罗哌卡因联合舒芬太尼用于硬膜外分娩镇痛的疗效.方法 选择2011年11月至2013年2月收治的120例足月初产妇,完全随机分为镇痛组和对照组各60例.镇痛组采用硬膜外腔持续注射0.1％罗哌卡因与0.4 mg/L舒芬太尼100ml,对照组为自然分娩.观察2组产妇疼痛情况、产程时间、分娩方式、产后出血量及新生儿Apgar评分.结果 镇痛组镇痛后各个时点(5、10、15、20、25、30 min)视觉模拟评分(VAS)较对照组均明显降低[分别为:(4.2±1.1)分比(9.4±1.1)分、(3.6±0.8)分比(9.4±1.0)分、(2.0±1.2)分比(9.3±0.9)分、(1.4±0.9)分比(9.3±1.2)分、(1.0±0.3)分比(9.4±1.1)分、(0.8±0.2)分比(9.4±1.3)分],差异有统计学意义(P＜0.05)；运动阻滞分别为0、1、2、3级时,镇痛组[分别为20例(33.3％)、25例(41.7％)、12例(20.0％)、3例(5.0％)]与对照组[4例(6.7％)、17例(11.7％)、24例(40.0％)、15例(25.0％)]同级比较,差异有统计学意义(P＜0.05)；镇痛组第一产程时间、剖宫产率、出血量均明显低于对照组[分别为:(426±46) min比(466±51) min、18.3％(11例)比25.0％(15例)、(137±25) ml比(148 ±24)ml] (P ＜0.05).结论 罗哌卡因和舒芬太尼两种药物联合用于硬膜外分娩镇痛镇痛效果确切,有助于分娩过程的顺利进行.

Clinical observation of ropivacaine combined with sufentanyl in labor analgesia

Objective To study the effect of ropivacaine joint sufentanyl used for epidural labor analgesia.Methods The study involved 120 cases of full-term primipara in our hospital from Nov.2011 to Feb.2012.The patients were randomly divided into the analgesia group and the control group.The patients of analgesia group were administrated with epidural space continuous injection of 0.1% ropivacaine and 0.4 mg/L sufentanyl.The degree of maternal pain,duration of the labor,delivery mode,bleeding volume and neonatal Apgar score were observed.Results After analgesia,the VAS score of analgesia group was （4.2 ± 1.1）,（3.6 ± 0.8）,（2.0 ± 1.2）,（1.4 ± 0.9）,（1.0 ±0.3）,（0.8 ±0.2） at 5min,10min,15min,20min,25min,30min respectively.The VAS score of control group was （9.4 ± 1.1）,（9.4 ± 1.0）,（9.3 ± 0.9）,（9.3 ± 1.2）,（9.4 ± 1.1）,（9.4±1.3） respectively.The VAS score of analgesia group was significantly lower than that in control group at all-time points （P 〈 0.05）.When nerve block was at 0,1,2,3 level,the effect in analgesia group [20 cases（33.3%）,25 cases （41.7%）,12 cases（20.0%）,3 cases （5.0%）] was higher than that in the control group [4 cases （6.7%）,17 cases （11.7%）,24 cases（40.0%）,15 cases（25.0%）] （P 〈0.05）.The first labor time,caesarean delivery rate and bleeding volume in analgesia group were significantly lower than those control group [（426 ± 46） min vs （466 ± 51）min,18.3% vs 25.0%,（137 ±25）ml vs（148 ±24）ml] （P〈0.05）.Conclusion The application of ropivacaine combination sufentanyl treating patients controlled epidural labor analgesia has good effectiveness with no adverse effect on maternal.