左布比卡因、芬太尼联合地塞米松用于分娩镇痛的效果观察

Analgesic effect of epidural combination of levobupivacaine,fentanyl and dexamethasone in natural delivery patients

目的观察自然分娩患者采用左布比卡因、芬太尼和地塞米松复合硬膜外用药的镇痛效果。方法选取2017年2月至2018年2月浙江省台州市中心医院接收的产妇92例,将其分为两组,每组46例。对照组硬膜外用药为左布比卡因+芬太尼,研究组在对照组基础上加用地塞米松。对比两组视觉模拟(VAS)疼痛评分、下肢运动神经阻滞发生率、镇痛起效时间、产程时间、分娩方式、胎儿窘迫发生率、阿氏评分及不良反应发生率。结果用药30min、用药60min、宫口开全、分娩后,研究组VAS评分明显低于对照组(t值分别为4.330、4.795、2.084、2.164,均P<0.05);研究组下肢运动神经阻滞发生率和镇痛起效时间均明显低于对照组(χ~2=3.866,t=3.534,均P<0.05);研究组第二产程时间明显低于对照组(t=2.012,P<0.05);两组胎儿窘迫发生率、1min阿氏评分、5min阿氏评分比较差异均无统计学意义(均P>0.05);研究组不良反应发生率明显低于对照组(χ~2=6.419,P<0.05)。结论自然分娩患者采用左布比卡因、芬太尼和地塞米松硬膜外复合用药镇痛效果确切。

Objective To observe the analgesic effect of epidural combination of levobupivacaine,fentanyl and dexamethasone in patients undergoing natural delivery.Methods During the period from February 2017 to February 2018,92 cases of maternity patients from Taizhou Central Hospital were selected as the subjects of this study,and were randomly divided into the study group and the control group,with 46 cases in each group.The control group received epidural administration of levobupivacaine-fentanyl,while the study group was treated with dexamethasone on the basis of the treatment in the control group.The VAS scores,lower limb motor nerve block,analgesic onset time,labor time,delivery mode,fetal distress incidence rate,Apgar score and rate of adverse reactions of two groups were compared.Results The scores of VAS in the study group after 30 min,60 min of medication,uterine opening and after delivery were significantly lower than those in the control group(t=4.330,4.795,2.084,2.164,P<0.05);the lower limb motor nerve block and the onset time of analgesia in the study group was significantly lower than that in the control group(χ~2=3.866,t=3.534,P<0.05).The second stage of labor in the study group was significantly shorter than that in the control group(t=2.012,P<0.05).the incidence of fetal distress,1-minute Apgar score and 5-minute Apgar score were not significantly different between the two groups(P>0.05).The incidence of adverse reactions in the study group was significantly lower than that in the control group(χ~2=6.419,P<0.05).Conclusion Natural labor patients were treated with levobupivacaine,fentanyl and dexamethasone for better analgesia.