蛛网膜下腔舒芬太尼与硬膜外腔罗哌卡因联合用于分娩镇痛中的效果评价

Evaluation of sufentanil and ropivacaine in combined spinal epidural anesthesia for labor analgesia

目的:探讨蛛网膜下腔舒芬太尼与硬膜外腔罗哌卡因联合用于分娩镇痛的效果、安全性和舒适性。方法:选取2017年5月~2018年7月在我院要求分娩镇痛的孕足月单胎初产妇60例,随机分为蛛网膜下腔舒芬太尼与硬膜外腔罗哌卡因联合组(S+L组)和单纯硬膜外腔罗哌卡因组(L组),每组各30例,观察两组镇痛模式的VAS镇痛效果、BCS舒适程度评分,硬膜外腔罗哌卡因总量、自控次数,不良反应等。结果:两组麻醉前后不同时段VAS疼痛评分及BCS舒适度评分差异有统计学意义(P<0.01),其中与T0比较,两组T1、T2、T3、T4及T5各时段VAS疼痛评分显著降低(P<0.01)及BCS舒适度评分显著升高(P<0.01),差异有统计学意义;与L组相比,S+L组T1、T2、T3、T4及T5各时段VAS疼痛评分显著降低(P<0.01)及BCS舒适度评分显著增加(P<0.01),差异有统计学意义。与L组相比,S+L组分娩结束时麻醉药物总量和自控镇痛次数明显减少(P<0.01),差异有统计学意义。与L组相比,S+L组分娩时不良反应及剖宫产率有所下降,差异无统计学意义(P>0.05)。结论:蛛网膜下腔舒芬太尼与硬膜外腔罗哌卡因联合麻醉,应用于分娩镇痛起效更快镇痛更完善,提高产妇的舒适程度,不良反应小,应用过程中需结合实际情况给予相应的剂量调整,以获得更好的麻醉效果。

Objective: To investigate the efficacy, safety and comfort of subarachnoid sufentanil combined with epidural ropivacaine for labor analgesia. Methods: 60 pregnant and full-term primipara who required labor analgesia in our hospital from May 2017 to July 2018 were randomly divided into subarachnoid sufentanil combined with epidural ropivacaine group(S + L group)and epidural ropivacaine group(L group), 30 cases in each group. The VAS analgesic effect and BCS analgesic effect of the two groups were observed. Comfort score, epidural ropivacaine total, self-control times, side effects, etc. Results: Compared with the control group, the onset time of ropivacaine in the experimental group was significantly shortened, the analgesic effect and comfort were significantly improved(P<0.05);the total amount of ropivacaine and the number of self-control were significantly reduced(P<0.05);the side effects were significantly reduced( P<0.05). Conclusions: Drunk, applied to labor analgesia faster analgesia more perfect, improve maternal comfort, side effects are small, the application process should be combined with the actual situation to give the appropriate dose adjustment, in order to obtain better anesthetic effect.