不同浓度罗哌卡因配伍舒芬太尼用于产妇分娩镇痛的临床效果观察

Study of clinical effect of the different concentration of ropivacaine combined with sufentanil for labor analgesia

目的:探讨不同浓度罗哌卡因复合舒芬太尼用于产妇分娩镇痛的临床效果。方法:选择本院2016年1月-2016年10月无痛分娩的孕妇120例,随机分为对照组(舒芬太尼4μg)、观察A组(舒芬太尼4μg+罗哌卡因2mg)、观察B组(舒芬太尼4μg+罗哌卡因3mg)、观察C组(舒芬太尼4μg+罗哌卡因4mg),每组30例。观察比较4组产妇镇痛情况、不同镇痛时点疼痛数字评价量表(NRS)评分、产程时间、催产素用量、阴道出血量及新生儿APGER评分情况。结果:4组产妇镇痛起效时间、显效时间、首剂维持时间及镇痛总时间比较均存在差异(P=0.000),镇痛起效时间及显效时间依次为观察B组<观察C组<观察A组<对照组,首剂维持时间及镇痛总时间依次为观察B组>观察C组>观察A组>对照组(P<0.001)。不同时点NRS评分4组比较均存在统计学差异(P=0.000),观察组的NRS评分均低于对照组,且观察B组<观察C组<观察A组(P<0.05)。4组产妇第二产程时间比较存在统计学差异,观察B组、观察C组第二产程时间较对照组明显延长(P<0.05)。结论:3mg罗帕卡因配伍舒芬太尼镇痛效果明显,起效快,作用强,维持时间久,有效减少产妇NRS评分,值得临床探索应用。

Objective：This study aims to investigate the clinical effect of the different concentration of ropivacaine com bined with sufentanil for labor analgesia.Methods：120 pregnant women with painless labor admitted in Ningbo Women＇s and Children＇s Hospital from January 2016 to October 2016 were randomly divided into control group （sufentanil 4μg）,observation group A （ropivacaine 2mg combined with sufentanil 4μg）,observation group B （ropivacaine 3mg combined with sufentanil 4μg） and observation group C （ropivacaine 4mg combined with sufentanil 4μg）,30 cases in each group.The analgesic situation,NRS score at different analgesia time point,birth process,amount of oxytocin required,vaginal bleeding and APGER score were compared among these four groups.Results：There were statistical differences in the onset time,effective time,first dose maintenance time and total time of analgesia among the four groups （P =0.000）.The onset time and effective time of analgesia of women in observation group B were shorter than those of women in observation group C,the onset time and effective time of analgesia of women in observation group C were shorter than those of women in observation group A,and the onset time and effective time of analgesia of women in observation group A were shorter than those of women in control group （P〈0.001）.The first dose maintenance time and total time of analgesia of women in observation group B were longer than those of women in observation group C,the first dose maintenance time and total time of analgesia of women in observation group C were longer than those of women in observation group A,and the onset time and effective time of analgesia of women in observation group A were longer than those women in control group （P〈0.001）.There were significant differences in NRS score at different time points （P=0.000）.The NRS scores at different time points of women in observation group were lower than those of women in control group,and the NRS scores of women in observation group B were lower than those of women in observation group C,the NRS scores of women in observation group C were lower than those of women in observation group A （P〈0.05）.There were statistically difference in the time during the second stage labor of women among the four groups,and the time during the second stage labor of women in the observation group B and C was sig nificantly longer than that of women in the control group（P〈0.05）.Conclusion：3mg ropivacaine combined with sufentanil has significant analgesic effectiveness,and has characteristics of rapid onset,strong effect,and long mainte nance time.It can also effectively reduce maternal NRS score.So 3mg ropivacaine combined with sufentanil is worthy of clinical popularization and application.