舒芬太尼配伍罗哌卡因硬膜外麻醉在无痛分娩中的效果观察

Effects of Sufentanil Combined with Ropivacaine for Epidural Anesthesia on Painless Parturition

目的:探讨无痛分娩过程中应用舒芬太尼配伍罗哌卡因行硬膜外麻醉的临床应用价值。方法:收集2013年7月—2015年6月间接诊的120例住院分娩产妇作为研究对象,通过随机数字表法将产妇分成观察组和对照组各60例。对照组60例产妇施行自然分娩,观察组60例产妇则施行舒芬太尼配伍罗哌卡因硬膜外麻醉无痛分娩。分析2组产妇的镇痛效果、分娩方式及产程情况。结果:观察组产妇的0级与Ⅰ级疼痛率显著高于对照组,Ⅱ级与Ⅲ级疼痛率显著低于对照组,差异均有统计学意义(P<0.05)。观察组产妇的自然分娩率为68.33%(41/60),显著高于对照组的45.00%(27/60);观察组产妇的剖宫产率为16.67%(10/60),显著低于对照组的36.67%(15/60),差异均有统计学意义(P<0.05)。观察组产妇的活跃期时间为(3.75±0.58)h,明显低于对照组的(5.12±0.61)h;观察组产妇的第二产程为(0.81±0.25)h,显著低于对照组的(1.12±0.48)h,差异均有统计学意义(P<0.05)。观察组新生儿出生后5、10 min的Apgar评分为(8.15±0.09)、(9.29±0.08)分,对照组为(8.17±0.08)、(9.28±0.11)分,2组差异无统计学意义(P>0.05)。观察组产妇中应用催产素率为15.00%(9/60),对照组为10.00%(6/60),2组的差异无统计学意义(P>0.05)。观察组患者的镇痛满意度为83.33%;分娩后4、8、12、24 h的改良Bromage评分为(1.11±0.66)、(0.68±0.52)、(0.43±0.48)、(0.28±0.44)分;且未见明显不良反应发生。结论:无痛分娩过程中应用舒芬太尼配伍罗哌卡因行硬膜外麻醉效果较好,且无明显不良反应,值得推广。

OBJECTIVE： To probe into the clinical application value of sufentanil combined with ropivacaine for epidural anesthesia in painless parturition. METHODS： 120 cases of hospitalized puerpera admitted from Jul. 2013 to Jun. 2015 were collected to be divided into observation group and control group via the random number table,with60 cases in each group. The control group received natural delivery,and the observation group were treated with sufentanil combined with ropivacaine for epidural anesthesia. The analgesic effects,delivery mode and stages of labor were analyzed in two groups. RESULTS： The pain rate of grade 0 and grade I of observation group were significantly higher than that of control group,while the pain rate of grade Ⅱand grade Ⅲ were significantly lower than that of control group,with statistical significance（ P 〈0. 05）. The rate of natural delivery of observation group was significantly higher than that of control group[68. 33%（ 41 /60） VS 45. 00%（ 27 /60） ],the rate of cesarean section of observation group was significantly lower than that of control group[16. 67%（ 10 /60） VS 36. 67%（ 15 /60） ],with statistical significance（ P 〈0. 05）. The duration of active period and the second stage of labor in observation group were significantly shorter than that in control group [（ 3. 75 ± 0. 58） h VS（ 5. 12 ± 0. 61） h,（ 0. 81 ± 0. 25） h VS（ 1. 12 ± 0. 48） h],the difference was statistically significant（ P 〈0. 05）. The Apgar score of newborn after the birth of 5,10 min of observation group were（ 8. 15 ± 0. 09） scores and（ 9. 29 ± 0. 08） scores,and of control group were（ 8. 17 ± 0. 08） scores and（ 9. 28 ± 0. 11）scores,the difference was on statistically significant（ P 〉0. 05）. The use rate of oxytocin in observation group was15. 00%（ 9 /60）,and in control group was 10. 00%（ 6 /60）,there was no significant difference（ P 〈0. 05）. The satisfaction of pain relief in observation group was 83. 33%; the improved Bromage scores after delivery of 4,8,12 and24 h were（ 1. 11 ± 0. 66） scores,（ 0. 68 ± 0. 52） scores,（ 0. 43 ± 0. 48） scores,（ 0. 28 ± 0. 44） scores; and there were noobvious adverse reactions. CONCLUSIONS： The effects of sufentanil combined with ropivacaine for epidural anesthesia on painless parturition is significant,with no obvious adverse reactions,which is worthy of promotion.