罗哌卡因联合舒芬太尼在无痛分娩中的应用效果

Application effects of Ropivacaine combined with Sufentanil in painless labor

目的研究罗哌卡因联合舒芬太尼在无痛分娩中的应用效果。方法选取2016年6月～2018年6月在中南大学湘雅二医院和湖南省妇幼保健院分娩的160例产妇,采用随机数字表法将其分为罗哌卡因组和联合用药组,每组各80例。罗哌卡因组使用罗哌卡因进行镇痛,联合用药组使用舒芬太尼和罗哌卡因混合液进行镇痛。比较两组产妇镇痛效果;检测垂体泌乳素(PRL)水平,比较两组产妇泌乳量;比较两组新生儿血气及Apgar评分。结果联合用药组产妇用药后镇痛起效时间和完全阻滞时间短于罗哌卡因组,持续时间长于罗哌卡因组,差异有统计学意义(P <0.05);联合用药组泌乳开始时间短于罗哌卡因组,且泌乳量及产后24 h、48 h的PRL浓度高于罗哌卡因组,差异有统计学意义(P <0.05);联合用药组胎儿血pH、动脉血氧分压(PaO2)水平及新生儿Apgar评分高于罗哌卡因组,动脉血二氧化碳分压(PaCO2)水平低于罗哌卡因组,差异有统计学意义(P <0.05);联合用药组产妇用药后疼痛缓解情况及乳房胀痛缓解情况均优于罗哌卡因组(P <0.05);联合用药组总满意度高于罗哌卡因组,总不良反应率低于罗哌卡因组,差异有统计学意义(P <0.05)。结论罗哌卡因联合舒芬太尼在无痛分娩中的效果更好,用药更安全。

Objective To study the application effects of Ropivacaine combined with Sufentanil on painless childbirth.Methods From June 2016 to June 2018,160 parturients delivered in the Second Xiangya Hospital of Central South University and Hu′nan Provincial Maternity and Child Health Care Hospital were selected,and they were divided into the Ropivacaine group and the combination group by random number table method,with 80 cases in each group.Ropivacaine group was treated by Ropivacaine for analgesia,and the combination group was treated by Sufentanil and Ropivacaine for analgesia.The analgesic effects of the two groups were compared.Prolactin(PRL)level was detected and lactation volume was compared between the two groups.Blood gas and Apgar scores of neonates were compared between the two groups.Results The analgesic effect time and complete block time of the combination group were shorter than those of Ropivacaine group,and the duration was longer than that of Ropivacaine group,the differences were statistically significant(P<0.05).The lactation initiation time of the combination group was shorter than that of Ropivacaine group,and the lactation volume and concentrations of PRL at postpartum 24 h and 48 h were higher than those of Ropivacaine group,the differences were statistically significant(P<0.05).The blood pH,artery blood oxygen partial pressure(PaO2)level of the fetus and Apgar score of neonates in the combination group were higher than those of Ropivacaine group,and artery blood partial pressure of carbon dioxide(PaCO2)level was lower than that of Ropivacaine group,the differences were statistically significant(P<0.05).The pain relief and breast distending pain relief in combination group were better than those in Ropivacaine group(P<0.05);the overall satisfaction of the combination group was higher than that of Ropivacaine group,and the total adverse reaction rate was lower than that of Ropivacaine group,the differences were statistically significant(P<0.05).Conclusion Ropivacaine combined with Sufentanil is more effective and safe for painless labor.