芬太尼与舒芬太尼复合罗哌卡因在分娩镇痛中的效果比较

Effects of Different Anesthetic Drugs Combined with Ropivacaine for Anesthesia in Childbirth

[目的]探讨舒芬太尼复合罗哌卡因与芬太尼复合罗哌卡因在分娩镇痛中的临床效果。[方法]本院妇产科住院的足月妊娠初产妇102例，按照随机数字表分为舒芬太尼复合罗哌卡因镇痛组（观察组）和芬太尼复合罗哌卡因镇痛组（对照组），每组各51例。观察组泵注药物为0．5ug／mL的舒芬太尼联合0．09％罗哌卡因100mL，对照组泵注药物为2．5ug／mL的芬太尼联合0．09％罗哌卡因100mL。观察两组患者给药前后各时间点VAS疼痛评分的变化，比较两组手术相关情况。[结果]给药前两组产妇的VAs疼痛评分相比较差异均无显著性（P〉0．05）；观察组产妇给药后5、10、30、60和90min患者VAs评分均低于对照组，且差异均有显著性（P〈0．05）；两组患者第一、第二程和第三产程用时比较差异无显著性（P〉0．05）；两组患者阴道分娩率和剖宫产率相比较差异无显著性（P〉0．05）；观察组心动过缓、呼吸抑制和低血压发生率均低于对照组，观察组胎儿宫内窘迫发生率低于对照组，且差异均有显著性（P〈0．05）。[结论]与芬太尼相比，舒芬太尼复合罗哌卡因在分娩镇痛中的镇痛效果更明显、起效快、不延长产程、对母婴无不良反应，可安全用于分娩镇痛，值得临床推广。

[Objective]To investigate the analgesic effects of sufentanil combined with ropivacaine and fentanyl combined with ropivacaine in labor. [Methods]In our hospital were 102 full-term primipara pregnancy cases, all of which were randomly divided into the sufentanil combined with ropivacaine pain group （observation group）, and fentanyl combined with ropivacaine （control group）. Each group had 51 cases each. The observation group used a drug infusion of 0.5 g/ml sufe（t;anil combined with 100ml of 0.09% ropivacaine, whereas the control group used a drug infusion of 2.5 g/ml fentanyl combined with 100 ml of 0.09% ropivacaine. Observations were made regarding the changes of VAS score at different time points before and after treatment, the duration of the birth process, mode of delivery, maternal complications, and fetal distress. [Results]Before treatment, the VAS pain scores of the two groups were not statistically significant difference （ P 〈0.05）. However, 5min, 10min, 30min, 60min, and 90rain following treatment, the VAS pain scores in the observation group were significantly lower than the corresponding scores in the control group, the differences being statistically significant （ P〈0.05）. Periods for the first stage, second stage, and third stage of laboring process were not significantly differences between the two groups （ P〈0.05）. The vaginal delivery rate and cesarean section rate between the two groups also showed no statistical differences （ P〈0.05）. The occurrence rates of complications including maternal analgesia, bradycardi- a, respiratory depression, and hypotension were higher in the control group than the observation group, the differ- ences were statistically significant （P〈0.05）. The incidence of fetal distress was also less in the control group, the difference being statistically significant （ P〈0.05）. [ConclusionlCompared with fentanyl combined with ropiva- caine, the analgesic effect of sufentanil combined with ropivacaine is more obvious and effective. It also does not prolong labor or create any adverse effects on maternal and child safety, and is worthy of promotion.