纳布啡用于硬膜外分娩镇痛对新生儿脐血血气及乳酸的影响

Effects of nabphine for epidural labor analgesia on neonatal umbilical arterial blood gas and lactate

目的探讨纳布啡复合罗哌卡因用于硬膜外自控分娩镇痛的临床效果及对新生儿脐动脉血气和乳酸的影响。方法 120例拟接受分娩镇痛的单胎足月初产妇随机分为观察组(60例)和对照组(60例)。观察组采用纳布啡复合罗哌卡因进行镇痛,对照组采用舒芬太尼复合罗哌卡因进行镇痛。胎儿娩出后,取脐动脉血3 mL行血气分析和乳酸值测定。比较两组产妇的VAS镇痛评分、运动阻滞评分、镇静评分以及不良反应发生例数。比较两组新生儿Apgar评分、脐动脉血气分析及乳酸结果。结果两组VAS镇痛评分差异无统计学意义(P>0.05),两组运动阻滞差异无统计学意义(P>0.05),两组镇静评分差异无统计学意义(P>0.05),观察组恶心呕吐及瘙痒发生率低于对照组,差异有统计学意义(P<0.05)。两组新生儿Apgar评分、脐动脉血气分析及乳酸结果比较差异无统计学意义(P>0.05)。结论罗哌卡因复合纳布啡可安全有效地用于分娩镇痛且对新生儿脐动脉血及乳酸无明显影响。

Objective To investigate the clinical effects of epidural controlled labor analgesia by nabulphine combined with ropivacaine on neonatal umbilical artery blood gas and blood lactate acid. Methods From December 2017 to August 2018, 120 single-fetus full-term primiparae who accepted analgesia labor were selected and randomly divided into control and study groups(n=60). The participants in control group were treated by ropibacaine and sufentanil, and those in study group were treated by ropibacaine and nabulphine. After the fetus was delivered, 3 mL umbilical arterial blood was collected to evaluate the blood gas and the lactic acid. The VAS pain score, modified Bromage score(MBS), sedation score, and adverse reactions were compared between the two groups. The neonatal Apgar score, umbilical arterial blood gas and lactic acid were also compared. Results There was no significant differences in the VAS score, MBS or sedation score between the two groups. The incidence of adverse reactions was significantly lower in the study group than in the control group(P<0.05). There was no significant difference in neonatal Apgar score, umbilical arterial blood gas or lactic acid between the two groups(P>0.05). Conclusion Ropivacaine combined with nabulphine can be used in epidural labor analgesia safely and effectively, and has no significant effect on neonatal umbilical artery blood or lactic acid.