低浓度罗哌卡因复合舒芬太尼用于硬膜外分娩镇痛的观察

Low concentration of ropivacaine combined with sufentanil for epidural analgesia in labor

[目的]观察低浓度罗哌卡因复合舒芬太尼用于硬膜外分娩镇痛的镇痛效果及对母婴的影响。[方法]将要求自然分娩的初产妇200例随机分为镇痛组和对照组,每组100例。镇痛组采用硬膜外分娩镇痛,对照组未行任何镇痛处理。观察两组视觉模拟评分(VAS评分)、产程时间、运动神经阻滞情况、分娩方式、催产素使用、产后出血量、新生儿Apgar评分、血浆皮质醇水平的变化。[结果]镇痛组活跃期、第二产程VAS评分低于对照组(P<0.01),活跃期明显缩短(P<0.01),第二产程、第三产程缩短不明显(P>0.05)。两组均无运动神经阻滞。两组分娩方式、催产素使用、产后出血量、新生儿Apgar评分比较差异均无统计学意义(P均>0.05)。镇痛组宫口开全时皮质醇水平低于对照组(P<0.05)。[结论]低浓度罗哌卡因复合舒芬太尼用于硬膜外分娩镇痛效果较好,且对母婴安全。

[ Objective ] To observe the effect of epidural analgesia with low concentration of ropiv- acaine combined with sufentanil in labor and the effects on neonates and gravidas. [ Methods] A group of 200 primigravidas who received spontaneous labor were divided into analgesia group and control group, 100 cases in each group. Analgesia group received epidural analgesia in labor. Control group did not receive analgesia. The visual analogue scate（VAS） , duration of labor, degree of motor block, mode of delivery, amount of oxytocin, postpartum hemorrhage, Apgar score of neonates, level of cortisol of the two groups were observed. [ Results ] The VAS of active period, second stage in analgesia group were lower than those in control group（P 〈0.01 ）. The active period in analgesia group reduced significantly （P 〈 0.01）, the differences in second stage and third stage were not significant. No motor block was found in the two groups. The difference in the mode of delive^3~, amount of oxytocin, postpartum hemorrhage and Apgar score of neonates between the two groups were not significant （ P 〉 0.05 ）. The level of cortisol in analgesia group at the time of cervical dilation 10cm was lower than that in control group （ P 〈 0.05）. [ Conclusion] Low concentration of ropivacaine combined with sufentanil is suitable for epidural analgesia labor, and safe to neonates and gravidas.