罗哌卡因-芬太尼脉冲式自控硬膜外泵镇痛在初产妇分娩中的应用效果

Application effect of Ropivacaine-Fentanyl pulsed self-controlled epidural analgesia in primipara delivery

目的探讨罗哌卡因-芬太尼脉冲式自控硬膜外泵镇痛在初产妇分娩中的应用效果。方法选取2017年8月~2018年4月我院收治的120例足月初产妇作为研究对象,根据随机数字表法分为观察组和对照组,每组各60例。观察组采用脉冲式自控硬膜外泵镇痛,对照组采用持续硬膜外阻滞泵镇痛。比较两组初产妇的第一产程时间、第二产程时间、罗哌卡因和芬太尼用量及脐血罗哌卡因浓度、第二产程时视觉模拟量表(VAS)评分、Bromage评分、满意度评分、催产素使用率、自然分娩率、新生儿Apgar评分及不良反应总发生率等情况。结果观察组产妇的第一、二产程时间短于对照组,罗哌卡因及芬太尼用量少于对照组,差异均有统计学意义(P<0.05);两组的脐血罗哌卡因浓度比较,差异无统计学意义(P>0.05);观察组产妇第二产程时VAS评分、Bromage评分及催产素使用率均低于对照组,差异有统计学意义(P<0.05);观察组产妇的满意度评分高于对照组,差异有统计学意义(P<0.05);观察组的自然分娩率高于对照组,差异有统计学意义(P<0.05);两组的新生儿Apgar评分及胎心率比较,差异无统计学意义(P>0.05);两组产妇的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论罗哌卡因-芬太尼脉冲式自控硬膜外泵对初产妇的镇痛效果更为显著。

Objective To investigate the application effect of Ropivacaine-Fentanyl pulsed self-controlled epidural analgesia in primipara delivery.Methods From August 2017 to April 2018,120 full-term primipara admitted to our hospital were selected as the research objects.According to the random number table method,they were divided into observation group and control group,with 60 cases in each group.The observation group used pulse self-controlled epidural pump for analgesia,and the control group used continuous epidural block pump for analgesia.The first stage of labor,the second stage of labor,the dosage of Ropivacaine and Fentanyl,the concentration of Ropivacaine in cord blood,the visual analogue scale(VAS)score during the second stage,Bromage score,satisfaction score,Oxytocin use rate,vaginal delivery rate,neonatal Apgar score and the total incidence of adverse reactions were compared between the two groups.Results The time of the first and second stages of labor in the observation group were shorter than those in the control group,and the dosage of Ropivacaine and Fentanyl were less than those in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the concentration of Ropivacaine in cord blood between the two groups(P>0.05).The VAS score during the second stage,Bromage score and oxytocin use rate of observation group were lower than those of control group,the differences were statistically significant(P<0.05).The satisfaction score of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).The rate of vaginal delivery in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).There was no significant difference in Apgar score and fetal heart rate between the two groups(P>0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion The Ropivacaine-Fentanyl pulsed self-controlled epidural pump is more effective in the analgesia of primipara.