瑞芬太尼静脉分娩镇痛在妊娠期高血压疾病中的应用

 目的 探讨瑞芬太尼静脉分娩镇痛对妊娠期高血压(妊高症)的应用效果及安全性。方法 选择符合顺产条件的妊高症产妇80例,随机分为观察组(静脉瑞芬太尼组)和对照组(硬膜外组),记录产妇不同时间点的平均动脉压(MAP)、心率(HR)、呼吸频率(RR)和脉搏氧饱和度(SpO₂);测定各个时点产妇的VAS评分,分析产妇的满意度评分;记录各个产程时间及母婴不良反应;测定新生儿Apgar评分及脐血血气。结果 两组在T₀(处理前10 min)时MAP、HR、RR差异无统计学意义;而在处理后10 min(T₁)、处理后60 min(T₂)、分娩后10 min(T₃)、分娩后2 h(T₄)这四个时间点的比较中,观察组的MAP均高于对照组,差异具有统计学意义(P<0.05);两组在T₀(处理前10 min)时的VAS评分差异无统计学意义,观察组在镇痛后各个时点(T₁-T₂)的VAS评分均高于对照组(P<0.05),但两组的患者满意度评分比较,差异无统计学意义(P>0.05);观察组的产程时间短于对照组(P<0.05);观察组产妇的低血压和下肢麻木发生率低于对照组(P<0.05),头晕发生率高于对照组(P<0.05);两组新生儿血气分析结果和窒息发生率比较,差异无统计学意义。结论 瑞芬太尼静脉分娩镇痛应用于妊高症产妇时循环稳定,依从性较好。

Applicability of remifentanil in labor analgesia for parturients with HDP

Objective To evaluate the efficacy and safety of remifentanil used in labor analgesia among patients with hypertensive disorders of pregnancy (HDP). Methods A total of 80 pregnant women with HDP were selected and randomly divided into two groups (n=40): the observation group (intravenous remifentanil group) and the control group (epidural group). Mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR) and pulse oxygen saturation(SpO₂) were recorded at different time points. VAS scores were measured at each time point, and the levels of satisfaction with labor analgesia were analyzed. The time of each stage of labor, maternal and neonatal adverse reactions were recorded. The Apgar score of newborns was determined and umbilical cord blood gas analysis was performed after delivery. Results There was no significant difference in MAP, HR or RR between the two groups at T₀ (10 min before treatment). However, the MAP of the observation group was significantly higher than that of the control group 10 min (T₁) and 60 min (T₂) after treatment, and 10 min (T₃) and 2 h (T₄) after delivery (P<0.05). As for VAS scores, there was no significant difference between the two groups at T₀ (P>0.05), but they were higher in the observation group than in the control group at each time point (T₁-T₂) after analgesia. There was no significant difference in patients’ level of satisfaction between the two groups (P>0.05). The incidence of hypotension and lower limb numbness in the observation group was lower than in the control group (P<0.05), but the incidence of dizziness was higher (P<0.05). There was no significant difference in blood gas indexes or in the incidence of asphyxia between the two groups (P>0.05). Conclusions Analgesia with remifentanil during labor is stable and ensures good compliance in patients with HDP.