罗哌卡因复合舒芬太尼用于硬膜外分娩镇痛对产程和母婴结局的影响

目的 观察产妇在产程潜伏期应用罗哌卡因复合舒芬太尼硬膜外分娩镇痛的临床效果,评价其可行性.方法 选取在2015年1月至2017年1月在湖北省宜昌市夷陵区妇幼保健计划生育服务中心自愿选择分娩镇痛的单胎初产妇420例,排除硬膜外阻滞禁忌症和药物过敏者,进行随机编号分组,每组210例.一组给予罗哌卡因复合舒芬太尼0.5μg/mL(S组),一组给予罗哌卡因复合芬太尼1.5μg/mL(F组).待宫口>2cm时进行硬膜外穿刺分娩镇痛,先硬膜外推注1%利多卡因5mL,10分钟后推注混合液8mL.记录VAS疼痛评分、产妇不良反应、新生儿Apgar评分、产后出血、产程时间等. 结果 产程各时点中,S组VAS疼痛评分均明显小于F组(t值分别为8.58、6.53、4.14、2.55,均P<0.05).两组产妇不良反应如头晕、呕吐、皮肤瘙痒的发生率差异无统计学意义(χ2值分别为0.15、0.10、0.09,均P>0.05),两组新生儿产后5min的Apgar评分差异也无统计学意义(t=1.54,P>0.05). 结论 硬膜外分娩镇痛产妇应用罗哌卡因复合舒芬太尼,有良好镇痛效果安全有效,可以临床推广.

Effects of ropivacaine combined with sufentanil for epidural analgesia on birth process and maternal and neonatal outcomes

Objective To observe the clinical effect of ropivacaine combined with sufentanil for epidural analgesia during birth latency and to evaluate its feasibility.Methods Totally 420 singleton prepueras without epidural anesthesia contraindications and drug allergy were randomly divided into two groups with 210 cases in each group.One group was given 0.5ug/mL ropivacaine combined with sufentanil (group S), and the other group was given 1.5ug/mL ropivacaine combined with fentanyl (group F).When the cervix was beyond 2cm, epidural puncture labor analgesia was provided.First 5mL lidocaine (1%) was pushed, and then 8mL mixture was pushed 10 minutes later.VAS pain score, maternal adverse reactions, neonatal Apgar score, postpartum hemorrhage and birth process were recorded.Results VAS scores of group S were obviously lower than those of group F (t value was 8.58, 6.53, 4.14 and 2.55, respectively, all P<0.05).There was no statistical significance between two groups in the incidence of adverse reactions such as dizziness, vomiting and pruritus (χ2 value was 0.15, 0.10 and 0.09, respectively, all P>0.05) as well as in 5min Apgar score (t=1.54,P>0.05).Conclusion Epidural analgesia with ropivacaine combined with sufentanil achieves good analgesic effect.It's safe and effective, and it is worthy of clinical promotion.