不同浓度舒芬太尼复合罗哌卡因用于分娩镇痛的临床研究

Randomized and double blindness clincal trail for different-dose sufentanil combined with ropivacaine on epidural analgesia for labor pain relief

目的观察不同浓度舒芬太尼和低浓度罗哌卡因配伍用于分娩镇痛的临床效果,探讨分娩镇痛中与低浓度罗哌卡因配伍的舒芬太尼最适宜浓度。方法选择80例ASAⅠ～Ⅱ级、头位、单胎、足月妊娠初产妇,年龄20～32岁,采用随机数字表法将80例受试者按1∶1∶1∶1比例分4组,分别为0.15%罗哌卡因复合安慰剂组(S0组);0.15%罗哌卡因复合舒芬太尼0.1μg/mL组(S1组);0.15%罗哌卡因复合舒芬太尼0.3μg/mL组(S2组);0.15%罗哌卡因复合舒芬太尼0.5μg/mL组(S3组)。并对产妇的生命体征、镇痛效果、产程变化、运动神经阻滞程度、分娩方式、新生儿Apgar评分等项目进行观察。结果 S2、S3组在麻醉后10 min时VAS评分较低,与S0组、S1组相比,差异有统计学意义;S1、S2、S3各组在麻醉后30、60 min时,VAS评分差异无统计学意义,但与S0组相比,差异有统计学意义;S3组皮肤瘙痒发生率明显增加;第一、二产程,新生儿Apgar评分四组差异无统计学意义。结论 S2组与S3组比较,0.3μg/mL舒芬太尼复合0.15%罗哌卡因用于硬膜外镇痛分娩安全有效,不良反应少。

Objective To compare the effect of different-dose sufentanil combined with 0.15% ropivacaineon epidural analgesia for labor pain relief. Methods 80 nulliparous were randomized to receive 0.15%ropivacaine with placebo（group S0） or sufentanil（0.1,0.3,0.5 μg/mL,group S1,S2,S3）through patient-controlled epidural analgesia.Maternal analgesia assessed by visual analog scale（VAS）were recorded before and after epidural block.Vital signs,mode of delivery and effect on infants were observed. Results The VAS scores of group S2 and S3 were significantly lower than those of group S0 and S1 at 10 min after epidural block.No significant difference was found in VAS score at 30 and 60 min after epidural block between group S1,S2,S3,however,the VAS score of the three groups were significantly lower than that of S0.There was no difference in the duration of first,second labor course and effect on infants. Conclusion The dosage of 0.15% ropivacaine with 0.3 μg/mL sufentanil is suitable for patient-controlled epidural analgesia for labor pain relief.