不同麻醉药物联合罗哌卡因行硬膜外阻滞的有效性和安全性分析

目的 探讨不同麻醉药物联合罗哌卡因行硬膜外阻滞的有效性和安全性.方法 选取2020年5月—2021年5月在金华市妇幼保健院接受分娩镇痛的单胎足月初产妇108例为研究对象,依据入院顺序将产妇分为A组和B组,每组各54例.在产妇宫口开至2 cm时,A组产妇给予0.3 mg/ml纳布啡联合0.1％罗哌卡因行产妇自控硬膜外镇痛...

Efficacy and safety analysis of different anesthetics combined with ropivacaine for epidural block in pregnant women in labor

Objective To investigate the efficacy and safety of different anesthetics combined with ropivacaine for epidural block in pregnant women in labor.Methods A total of 108 full-term single fetus primiparas who received labor analgesia in Jinhua Maternal and child Health Care Hospital from May 2020 to May 2021 were selected.According to the order of admission,the parturients were divided into group A and group B,there were 54 cases in each group.When the vaginal opening reached 2 cm,54 parturients in group A were given 0.3 mg/ml nalbuphine combined with 0.1%ropivacaine for controlled epidural analgesia,while 54 parturients in group B were given 0.3μg/ml sufentanil combined with 0.1%ropivacaine hydrochloride for controlled epidural analgesia.The first time of self-controlled analgesia,the number of self-controlled analgesia presses,the onset time of analgesia,the number of effective presses,the total amount of selfcontrolled analgesia drugs and the consumption of ropivacaine per hour were recorded in two groups.Visual analogue scale(VAS)scores and the occurrence of adverse reactions were compared at different time points.Partial oxygen pressure(PO₂),pH value,partial carbon dioxide(PCO₂),lactin level and neurobehavioral score were compared.Results The first-time patient-controlled analgesia time and the effect time of analgesia in group A[(62.34±10.25)minutes,(14.25±6.11)minutes]were shorter than those in group B[(131.56±10.14)minutes,(18.02±6.74)minutes],and the differences were statistically significant(t=35.279,3.045,all P<0.05).The hourly consumption of Ropivacaine[(9.54±2.11)mg/h]in group A was higher than that in group B[(7.32±2.04)mg/h],and the difference was statistically significant(t=5.559,P<0.05).The number of patient-controlled analgesia presses,the number of effective presses and the total amount of patient-controlled analgesia drugs in group A[(5.02±0.98)times,(5.68±1.24)times and(36.98±5.87)ml]were less than those in group B[(2.13±0.47)times,(2.16±1.18)times and(25.06±4.21)ml],and the differences were statistically significant(t=19.54,15.111 and 12.126,all P<0.05).The VAS score[(4.95±2.48)points]of puerpera with cervix fully opened in group A was higher than that in group B[(3.92±2.28)points],and the difference was statistically significant(t=2.247,P<0.05).There was no significant difference in PO₂,pH,PCO₂,lactic acid and comparasion of neurobehavioral score in 24 hours after operation between the two groups(all P>0.05).The incidence of urinary retention in group A(18.52%)was lower than that in group B(29.63%),the difference was statistically significant(χ²=5.475,P<0.05).Conclusion Compared with sufentanil,the analgesic effect of nalbuphine during epidural anesthesia was faster and the incidence of urinary retention was reduced,but the analgesic effect of nalbuphine was worse and the consumption of ropivacaine was higher when the uterus was fully open.Both can reduce labor pain and have no effect on the newborn.