分析无痛分娩中应用罗哌卡因、舒芬太尼腰硬联合麻醉的效果

Analysis of Combined Spinal-epidural Anesthesia With Ropivacaine and Sufentanil in Painless Delivery

目的探析无痛分娩采取罗哌卡因联合舒芬太尼腰硬联合麻醉效果及其对产妇母婴结局的影响。方法将2018年1—12月本院接收的进行无痛分娩的产妇100例纳入本次研究,随机分为四组,A组采取国产罗哌卡因,B组采取舒芬太尼,C组采取国产罗哌卡因联合舒芬太尼,D组则接受进口罗哌卡因联合舒芬太尼,对比四组产妇分娩方式、新生儿Apgar评分、产妇各时间点VAS评分。结果 A组、B组、C组及D组镇痛前VAS评分差异无统计学意义(P> 0.05);镇痛后30 min、第二产程及第三产程VAS评分方面,C组及D组较A组和B组更低,差异存在统计学意义(P <0.05);而C组及D组差异无统计学意义(P> 0.05);C组及D组自然分娩率较A组及B组更高,差异存在统计学意义(P <0.05);C组与D组剖宫产率及自然分娩率差异无统计学意义(P> 0.05);在新生儿Apgar评分方面,A组、B组、C组及D组差异无统计学意义(P> 0.05)。结论无痛分娩期间,采取国产罗哌卡因联合舒芬太尼腰硬联合麻醉具有显著效果,其有助于减轻患者分娩疼痛,促进自然分娩率的提高,改善母婴结局。

Objective To explore the effect of combined spinal-epidural anesthesia with ropivacaine and sufentanil in painless childbirth and its effect on maternal and infant outcomes.Methods 100 parturients who gave birth painlessly in our hospital from January to December 2018 were included in this study.They were randomly divided into four groups: group A was treated with domestic ropivacaine,group B with sufentanil,group C with domestic ropivacaine and sufentanil,and group D with imported ropivacaine and sufentanil.The delivery mode,neonatal Apgar score and VAS score at each time point were compared among the four groups.Results There was no significant difference in VAS score before analgesia among group A,group B,group C and group D (P > 0.05).The VAS scores of 30 minutes after analgesia,the second stage of labor and the third stage of labor in group C and D were lower than those in group A and B,and the difference was statistically significant (P < 0.05).There was no significant difference between group C and group D (P > 0.05).The natural delivery rate of group C and group D was higher than that of group A and group B,and the difference was statistically significant (P < 0.05).There was no significant difference in cesarean section rate and natural delivery rate between group C and group D (P > 0.05).There was no significant difference in Apgar score among groups A,B,C and D (P > 0.05).Conclusion During painless childbirth,domestic ropivacaine combined with sufentanil combined spinal-epidural anesthesia has a significant effect,which can help to alleviate the pain of childbirth,promote the increase of natural childbirth rate and improve maternal and infant outcomes.