罗哌卡因复合舒芬太尼在硬膜外麻醉无痛分娩中的临床观察

Clinical observation of ropivacaine combined with sufentanil in painless delivor epidural anesthesia

目的研究罗哌卡因复合舒芬太尼在硬膜外麻醉分娩镇痛的安全性及有效性。方法随机选择96例初产临产妇,以入产房的单双例分为两组:A组注入0.2%罗哌卡因与5μg舒芬太尼混合液6m L,后接硬膜外电子止痛泵维持剂量7m L/h(n=48例);B组为普通分娩对照组(n=48例)。观察两组分娩过程的疼痛分级和胎儿评分,产妇的血压心率变化,产妇的VAS评分,产程时间,顺产率,产后尿潴留等情况。结果疼痛分级效果镇痛组显著优于对照组(P<0.01),产程时间长于镇痛组,差异有显著性意义(P<0.05);B组产妇在产程中MAP、HR明显升高,变化有明显差异(P<0.05);A组剖腹产率比普通组低(P<0.05);缩宫素使用率、围生期出血、Apgar评分、产后尿潴留等比较两组无明显差异(P>0.05)。结论罗哌卡因复合舒芬太尼在硬膜外用于分娩镇痛可以降低分娩时期的疼痛,提高舒适度和安全性。

Objective To explore the safety and effectiveness of ropivacaine combined with sufentanil in painless delivor epidural anesthesia. Methods 96 cases of primipara were randomly selected and divided into two groups according to single and double cases in delivery room. Patients in group A were treated with injection of 0.2% ropivacaine and 5 ~ g sufentanil mixture 6mL, and then maintenance dose of epidural analgesia pump 7mL/h （n=48）. Patients in group B were treated with general delivery （n=48）. Pain classification and fetal outcome during delivery, maternal blood pressure and heart rate changes, maternal VAS score, labor time, labor rate, postpartum urinary retention and so on of the two group were observed. Results The analgesic effect of pain grade group was significantly better than that of control group （P 〈 0.01）. The labor time was longer than that in the analgesia group, and the difference was significant （P 〈 0.05）. The MAP and HR were significantly higher in the group B, and the changes were significantly different （P 〈 0.053. The caesarean section rate of group A was lower than that of normal group （P 〈 0.05）. There was no significant difference between the two groups （P 〉 0.05） in the rate of oxytocin use, perinatal bleeding, Apgar score, postpartum urinary retention. Conclusion Ropivacaine combined with sufentanil in painless delivor epidural anssthesig can reduce the pain during childbirth, and improve comfort and safety.