舒芬太尼配伍罗哌卡因硬膜外麻醉在无痛分娩中的效果观察

Observation on effect of sufentanil combined with ropivacaine epidural anesthesia in painless labor

目的对无痛分娩中舒芬太尼配伍罗哌卡因硬膜外麻醉的应用效果进行分析。方法 114例分娩产妇,随机分为对照组与观察组,各57例。对照组未使用任何镇痛药物行自然分娩方法 ,观察组以舒芬太尼联合罗哌卡因硬膜外麻醉无痛分娩。观察比较两组产妇镇痛效果、产程时间以及分娩方式。结果观察组镇痛效果明显优于对照组,差异具有统计学意义(P<0.05)。观察组第一产程活跃期(3.1±1.2)h短于对照组的(4.8±1.8)h,第二产程活跃期(0.7±0.5)h短于对照组的(1.3±0.4)h,差异具有统计学意义(P<0.05)。观察组顺产40例、剖宫产12例、阴道助产5例,对照组顺产26例、剖宫产23例、阴道助产8例,两组比较差异具有统计学意义(P<0.05)。观察组新生儿5 min Apgar评分(8.10±0.05)分与对照组的(8.12±0.08)分比较差异无统计学意义(P>0.05);观察组10 min Apgar评分(9.25±0.10)分与对照组(9.26±0.11)分比较,差异无统计学意义(P>0.05)。结论无痛分娩中,舒芬太尼联合罗哌卡因硬膜外麻醉方式的应用可取得显著镇痛效果,有助于顺产率的提高,同时对新生儿无不良影响,应在临床实践中推广应用。

Objective To analyze the application effect of sufentanil combined with ropivacaine epidural anesthesia in painless labor.Methods A total of 114 pregnant women were randomly divided into control group and observation group,with 57 cases in each group.The control group received natural labor without any analgesic drug,and the observation group received painless labor by epidural anesthesia with sufentanil and ropivacaine.Observation and comparison were made on analgesic effect,duration of labor and mode of delivery between two groups.Results The observation group had obviously better analgesic effect than the control group,and the difference was statistically significant（P〈0.05）.The observation group had shorter active period of the first stage as（3.1±1.2） h than（4.8±1.8） h in the control group,and shorter active period of the second stage as（0.7±0.5） h than（1.3±0.4） h in the control group.Their difference was statistically significant（P〈0.05）.The observation group had 40 cases of spontaneous labor,12 cases of cesarean section,5 cases of vaginal delivery,while the control group had 26 cases of spontaneous labor,23 cases of cesarean section,8 cases of vaginal delivery.Their difference was statistically significant（P〈0.05）.The observation group had no statistically significant difference in neonatal 5 min Apgar score as（8.10±0.05） points comparing with（8.12±0.08） points in the control group（P〉0.05）.The observation group had no statistically significant difference in neonatal 10 min Apgar score as（9.25±0.10） points comparing with（9.26±0.11） points in the control group（P〉0.05）.Conclusion In painless labor,application of sufentanil and ropivacaine epidural anesthesia shows significant analgesic effect,and can help to improve the rate of natural labor,with no adverse effects on the newborn.It should be popularized and applied in clinical practice.