罗哌卡因腰硬联合麻醉用于无痛分娩的效果及对母婴的影响

Effect of ropivacaine on painless delivery and its effect on mother and infant

目的 探讨罗哌卡因腰硬联合麻醉在无痛分娩中的效果及对母婴的影响.方法 选择2016年3月至2017年5月在太原市第八人民医院接受无痛分娩的产妇64例为观察组,应用罗哌卡因实施腰硬联合麻醉,另选择同期自然分娩的产妇42例为对照组,比较两组分娩疼痛程度、妊娠结局及不良反应.结果 观察组正常分娩率、缩宫素使用率分别为50.00%、7.81%,均优于对照组（均P＜0.05）;观察组新生儿出生1 min、5 min Apgar评分分别为（8.92 ±1.20）分、（9.43 ±0.56）分,均高于对照组（t＝5.362、4.036,均P＜0.05）;观察组54.69%产妇产后泌乳量充足,与对照组差异无统计学意义;分娩后,观察组NO水平高于对照组[（94.2 ±9.6） μmol/L比（82.6 ±5.6） μmol/L,皮质醇水平低于对照组[（726.3 ±68.1） ng/mL比（892.7 ±136.4）ng/mL,差异均有统计学意义（均P＜0.05）.结论 罗哌卡因腰硬联合麻醉是无痛分娩的理想方式,镇痛效果好,能够提高自然分娩率,对母婴影响小.

Objective To investigate the effect of ropivacaine on painless delivery and its effect on mother and infant.Methods From March 2016 to May 2017,64 cases of maternal painless labor demand in the Eighth People＇s Hospital of Taiyuan were chosen as the observation group ,42 cases of natural childbirth pregnant women in the Eighth People＇s Hospital of Taiyuan were selected as control group .The degree of labor pain,pregnancy outcome and the effect on mother and infant were compared .Results The excellent rate of normal delivery ,oxytocin usage rate in the observation group were 50%,7.81%,respectively,which were better than those in the control group （ all P〈0.05）.The Apgar scores of newborns at 1 min 5 min after birth in the observation group were （8.92 ±1.20）points, （9.43 ±0.56）points,respectively,which were higher than those in the control group （t =5.362,4.036,all P〈0.05）.The postpartum lactation of the observation group was 54.69%,and had no statistically significant difference compared with the control group .After delivery,the level of NO in the observation group was higher than that in the control group [（94.2 ±9.6） μmol/L vs.（82.6 ±5.6） μmol/L],and the cortisol level was lower than that in the control group [（726.3 ±68.1）ng/mL vs.（892.7 ±136.4）ng/mL],the differences were statistically significant （all P〈0.05）.Conclusion Ropivacaine combined with spinal and epidural anesthesia is an ideal way for painless delivery, with good analgesic effect ,which can improve the natural delivery rate and has little effect on mother and child .