0.1%罗哌卡因复合舒芬太尼在可行走分娩镇痛中的应用

目的探讨0.1%罗哌卡因复合舒芬太尼在可行走分娩镇痛中应用的安全性和可行性。方法选择待产妇280例,根据自愿要求分娩镇痛的140例为分娩镇痛组（Z组）,常规分娩组140例（C组）。镇痛组（Z组）宫口开至3 cm时行硬膜外穿刺操作,成功后开始镇痛;常规分娩组（C组）不做麻醉干预。观察组记录镇痛前即刻（T0）及镇痛后10 min（T1）、30 min（T2）、60 min（T3）、宫口开全时（T4）VAS评分,C组记录宫口开3 cm时（T0）及以后10 min（T1）、30 min（T2）、60 min（T3）、宫口开全时（T4）VAS评分;两组中转剖宫产率、产程进展及产后出血情况、两组新生儿Apgar评分。结果两组产妇改良Bromoge分级评分都是0分,两组VAS评分有显著差异（P〈0.01）,两组间剖宫产率比较有显著差异（P〈0.01）。结论 0.1%罗哌卡因复合舒芬太尼应用于分娩镇痛中是可行且比较安全的。

The Application of 0.1% Ropivacaine Combined With Sufentanil During Walkable Epidural Labor Analgesia

Objective To investigate the feasibility and safety of 0.1% ropivacaine combined with sufentanil for epidural walking labor analgesia. Methods 280 parturient patients were randomly divided into two groups, 140 parturient patients in each group： group Z（0.1% ropivacaine combined with sufentanil） and group C（spontaneous labor, control group）. In group Z, 0.1% ropivacaine combined with sufentanil was administered into epidural space when the patient was confirmed cervical dilatation=3 cm, but nothing was to do about anesthesia in group C. The VAS scores at the moment of immediately before analgesia（T0）, and at the moment of 10 min（T1）, 30 min（T2） and 60 min（T3） after analgesia, and the VAS scores at the moment of the cervical dilatation=10 cm（T4） were recorded in group Z, the VAS scores at the moment of the cervical dilatation=3 cm（ T0）, and the VAS scores at the moment of 10 min（T1）, 30 min（T2）, 60 min（T3） after the cervical dilatation=3 cm, and the VAS scores at the moment of the cervical dilatation =10 cm（T4） were recorded in group C（T4）. The stage of labor, blood loss after delivery, cesarean section rate, neonatal Apgar scores were monitored. Results Compared group Z with group C, no significant differences were found in modified Bromage scores. The VAS scores and the cesarean section rate was both significantly difference between the two groups（P〈0.01）. Conclusion 0.1% ropivacaine combined with sufentanil is feasible and safe for walkable labor analgesia.