舒芬太尼联合罗哌卡因在分娩镇痛中对产间发热的影响

Effects of sufentanil and ropivacaine for labor analgesia on maternal inpartum fever

目的探讨舒芬太尼联合罗哌卡因在分娩镇痛中对产间发热的影响,为临床用药提供指导和借鉴。方法收集我院2015年1月-2016年10月足月、单胎分娩的初产妇90例,按随机数字法分为观察组和实验组各45例。观察组产妇硬膜外注射0.1%罗哌卡因与0.5μg/ml舒芬太尼混合液,对照组产妇仅给予0.1%罗哌卡因镇痛,比较两组产妇、新生儿各项指标、产间发热发生率、剖宫产率、鼓膜体温、IL-6水平、感觉阻滞平面及Bromage评分。结果两组产妇产程时间、破膜至分娩时间、镇痛时间及镇静药物用量相比,差异有统计学意义(P<0.05);观察组产间发热发生率及剖宫产率均显著低于对照组,差异有统计学意义(P<0.05);镇痛开始后4h、5h及分娩后1h,观察组产妇鼓膜体温及IL-6水平均显著低于对照组,差异有统计学意义(P<0.05);观察组Bromage评分显著优于对照组,差异有统计学意义(P<0.05)。结论舒芬太尼联合罗哌卡因应用于分娩镇痛,可有效降低产间发热率,缩短产程,增加自然分娩率,同时还可减轻运动阻滞,值得临床推广和应用。

Objective To explorer the effects of sufentanil and ropivacaine for labor analgesia on maternal inpartum fever,providing guidance and reference for clinical medication.Methods 90 nulliparous parturients in active labor were collected from January 2015 to October 2016.All the maternal were divided into observation group （45 cases）and ex-perimental group（45 cases）.The observation group maternal was given 0.1% ropivacaine and 0.5 μg/ml sufentanil mixture,the control group was only given 0.1%ropivacaine.The maternal,newborn,the indicators fever incidence,ce-sarean section rate,tympanic membrane temperature,IL-6 level,sensory block plane and Bromage score were compared between two groups.Results Two groups of maternal labor time,rupture to delivery time,the dosage of analgesic and sedative drugs of were statistically significant difference （P 〈0.05）.The fever incidence between production and cesar-ean section rate of observation group were significantly lower than the control group,the difference was statistically sig-nificant （P 〈0.05）.After analgesia 4 h,5 h and 1 h childbirth,the maternal tympanic membrane temperature and IL-6 level of observation group was lower than the control group,the difference was statistically significant （P 〈0.05）.The Bromage score of observation group was significantly better than control group,the difference was statistically signifi-cant （P 〈0.05）.Conclusion sufentanil and ropivacaine for labor analgesia on maternal inpartum fever not onely can ef-fectively reduce fever production rate,shorten the labor,increase the natural births,but also can reduce the motion block.It should be worthy of clinical application and promotion.