舒芬太尼替代芬太尼应用于分娩镇痛的安全性分析

Safety Analysis of Labour Analgesia with Sufentanil Instead of Fentanyl

目的探讨舒芬太尼替代芬太尼在无痛分娩应用的安全性和可行性。方法将2014年8月-2016年2月在我院接受自然生产的初产妇300例,按患者入院的先后顺序及意愿选择分娩方式分为芬太尼组、舒芬太尼组和对照组3组,每组100例。对照组自然生产,芬太尼组、舒芬太尼组分别采用芬太尼和舒芬太尼无痛分娩,产程若出现宫缩乏力加滴缩宫素。观察总产程时间,视觉模拟评分(visual analogue scale,VAS)进行疼痛评分,并发症,新生儿Apgar 1、10 min评分。结果总产程时间对照组明显短于芬太尼组[(402.8±81.9)min vs.(476.5±84.8)min,q=9.185,P<0.05];疼痛VAS评分舒芬太尼组、芬太尼组明显低于对照组[(3.0±0.7)分vs.(7.1±0.7)分,q=58.571,P<0.05;(3.3±0.7)分vs.(7.1±0.7)分,q=54.286,P<0.05]。3组产后并发症发生率无统计学差异(χ~2=0.150,P=0.928)。3组新生儿Apgar 1、10 min评分有统计学差异(P<0.05),但都在8分以上,差异无实际临床意义。结论舒芬太尼应用于无痛分娩时联合缩宫素能获得满意的镇痛效果,安全有效。

Objective To study the effect of sufentanil instead of fentanyl applied in painless labour in pregnant women.Methods A total of 300 primiparas in our hospital were selected as subjects, and randomly assigned to a control group （C） or two treatment groups （F or S groups）, with 100 in each group.The C group had natural delivery.The S and F groups were treated with sufentanil and fentanyl in painless labour,respectively.The labour time, VAS scores, complications, and Apgar scores at 1 and 10 min were recorded.Results The labour time was significantly shorter in the C group than the F group [（402.8±81.9） min vs.（476.5±84.8） min, q=9.185, P〈0.05].The VAS scores were significantly lower in the S and F groups than that in the C group [（3.0±0.7） points vs.（7.1±0.7） points, q=58.571, P〈0.05;（3.3±0.7） points vs.（7.1±0.7） points , q=54.286, P〈0.05].There was no significant difference among the three groups in postoperative complications （x2=0.150, P=0.928）.The neonatal Apgar scores among the three groups at 1 min and 10 min had significant differences （P〈0.05）, all of which were above 8 points, without clinical significance.Conclusion Sufentanil applied in painless labour in pregnant women is safe and effective.