不同浓度舒芬太尼联合罗哌卡因在分娩镇痛中应用效果

Efficacy of Different Concentrations of Sufentanil Combined with Ropivacaine in Labor Analgesia

目的探讨不同浓度舒芬太尼联合罗哌卡因在分娩镇痛中应用效果。方法将湛江市第二人民医院自愿行脊膜外腔阻滞镇痛分娩的孕产妇200例随机分为5组,分别为0.1%罗哌卡因＋0.3μg/m L舒芬太尼（A组）、0.1%罗哌卡因＋0.4μg/m L舒芬太尼（B组）、0.1%罗哌卡因＋0.5μg/m L舒芬太尼（C组）、0.1%罗哌卡因＋0.6μg/m L舒芬太尼（D组）、0.1%罗哌卡因＋0.7μg/m L舒芬太尼（E组）,每组各40例,均采用脊膜外腔阻滞镇痛分娩。结果 5组孕妇镇痛即刻、镇痛后10 min、镇痛后30 min、子宫口开6 cm、子宫口全开时的VAS评分及镇痛起效时间比较,差异无统计学意义（P〉0.05）;A组产妇的第一产程时间显著高于B、C、D、E组,差异有统计学意义（P〈0.05）;D组、E组产妇产后总计不良反应显著高于A、B组,差异有统计学意义（P〈0.05）。结论 0.4μg/m L的舒芬太尼联合0.1%罗哌卡因在硬膜外分娩镇痛效果好,对产程影响小,不良反应率低。

Objective To explore the efficacy of different concentrations of sufentanil combined with ropivacaine in childbirth anal- gesia. Methods 200 cases with epidural block analgesia were randomly divided into five groups： 0. 1% ropivacaine ＋ 0. 3μg/mL sufentanil （group A） , 0. i% ropivacaine ＋ 0. 4 μg/mL sufentanil （group B）, 0. 1% ropivacaine ＋0. 5 μg/mL sufentanil （group C） , 0. 1% ropivacaine ＋0. 6 μg/mL fentanyl （group D）, 0. 1% ropivacaine ＋0. 7 μg/mL sufentanil （group E）, with 40 patients in each group. Results There were no significant differences in VAS scores at the analgesic immediately, 10 min after analgesia, 30 min after analgesia, uterine opening 6cm and analgesic onset time among five groups （P 〉 0. 05 ）. The first active period of time of the group A was significantly higher than that of the group B, C, D, E, P 〈 0. 05. The total adverse reactions of group D and group E were signifi- cantly higher than that of group A and group B, P 〈 0. 05. Conclusion The efficacy of 0. 4μg/mL sufentanil combined with 0. 1% rop- ivacaine in epidural delivery analgesic is well, with little impact of active period and low adverse reaction rate.