舒芬太尼用于硬膜外分娩镇痛的临床观察

Study of Sufentanil Used in Epidural Anesthesia for Labor Analgesia

目的比较舒芬太尼与芬太尼用于分娩镇痛的镇痛效果、对产程、母婴的影响及不良反应。方法年龄25～28岁，ASAⅠ级，经阴道分娩足月初产妇120例，分为3组：舒芬太尼组（S组）：泵内配置舒芬太尼0．5mg／L＋0．1％罗哌卡因；芬太尼组（F组）：泵内配置芬太尼2mg／L＋0．1％罗哌卡因；C组：对照组，未用任何镇痛方法。观察镇痛组硬膜外给药前及给药10min、30min、60min、120min、180minVAS评分，首次加药时间、宫口开大程度、宫缩间期、分娩方式、产后出血量、缩宫素使用情况、新生儿Apgar评分等。结果与C组比较，S组和F组产妇镇痛效果满意（P〈0．01）。S组和F组各时点VAS评分差异无统计学意义（P〉0．05）。3组间产程时间、宫缩间期、分娩方式、产后出血量、缩宫素使用量、新生儿窒息发生率、剖宫产率及运动神经的阻滞的比较差异均无统计学意义（均P〉0．05），但舒芬太尼有使第一产程缩短的趋势。结论舒芬太尼用于硬膜外阻滞分娩镇痛能提供良好的镇痛效果，可缩短活跃期，对母婴均无不良影响。

Objective To evaluate effects and safety of sufentanil for labor analgesia as compared with fentanyl. Methods One hundred and twenty ASA I full term primipara who were 25-28 years old and had a single fetus were expected to have a vaginal delivery and were randomly divided into 3 groups： group S （n=40）, sufentanil 0.5 mg/L＋0. 1% ropivacaine in pump, group F（n=40）, fentanyl 2 mg/L＋0. 1% ropivacaine in pump, group C（n=40）, received no analgesia. The VAS score, first inject drug time, cervix dilation, uterine intermittent of uterus contraction, mode of delivery, postpartum hemorrhage, amount of oxytocin required and Apgar score of neonates were recorded. Results Compared to group C, group S and group F had higher rate of satisfactory analgesia（P〈0.01）. There was no difference in VAS score（P〉0.05） between group S and group F. There was no significant difference in brith process time, intermittent of uterus contraction , mode of delivery, postpartum hemorrhage, amount of oxytocin required, rate of neonatal asphyxia and cesarean section, degree of motor block（P〉0.05）. There was the first stage of labor shortened tendency with group S. Conclusion Epidural anesthesia with sufentanil is effective and safety for labor analgesia, the active stage of labor can be shortened.