舒芬太尼复合罗哌卡因在剖宫产产妇中的镇痛效果及对胃肠道功能的影响

Analgesic Effect of Sufentanil Combined with Ropivacaine in Cesarean Section and Its Effect on Gastrointestinal Function

目的:探讨舒芬太尼复合罗哌卡因在剖宫产产妇中的镇痛效果及对胃肠道功能的影响。方法:选择2017年4月至2018年4月于我院进行剖宫产产妇60例进行研究,随机分为观察组(n=32)和对照组(n=28),对照组应用罗哌卡因镇痛,观察组采用舒芬太尼复合罗哌卡因镇痛。比较两组麻醉后自主排尿时间、首次下床活动时间、有效镇痛时间、术后12h、24h及48h疼痛评分、哺乳情况、胃肠道功能恢复时间不良反应发生情况。结果:观察组自主排尿时间、首次下床活动时间均显著低于对照组,有效镇痛时间高于对照组(P<0.05);观察组术后12h、24h及48h疼痛评分均显著低于对照组,差异显著(P<0.05);观察组初乳时间低于对照组,24h哺乳次数显著高于对照组,差异显著(P<0.05);术后,观察组肠鸣音恢复时间、肛门排气时间及肛门排便时间均显著低于对照组,差异显著(P<0.05);两组产妇低血压、心动过缓、恶心及呕吐均总发生率分别为9.38%、35.71%,比较差异具有统计学意义(P<0.05)。结论:剖宫产产妇应用舒芬太尼复合罗哌卡因镇痛效果显著,可有效改善患者胃肠道功能,安全有效。

Objective:To explore the analgesic effect of sufentanil combined with ropivacaine in cesarean section and its effect on gastrointestinal function.Methods:60 cases of cesarean section mothers in our hospital from April 2017 to April 2018 were selected for the study,were randomly divided into the observation group(n=32)and the control group(n=28).The control group was treated with ropivacaine for analgesia,and the observation group was treated with sufentanil combined with ropivacaine for analgesia.The time of spontaneous urination after anesthesia,the time of the first movement out of bed,the effective analgesia time,the pain score at 12h,24h and 48h after the operation,the nursing condition,and the adverse reactions of gastrointestinal function recovery time were compared between the two groups.Results:The time of spontaneous urination and the time of getting out of bed for the first time in the observation group was significantly lower than that in the control group,and the effective analgesia time was higher than that in the control group(P<0.05).The pain scores of the observation group at 12h,24h and 48h after surgery were significantly lower than those of the control group(P<0.05).The colostrum time in the observation group was lower than that in the control group,and the number of lactation at 24h was significantly higher than that in the control group(P<0.05).After surgery,the recovery time of bowel sound,anal exhaust time and anal defecation time in the observation group were significantly lower than those in the control group(P<0.05).The total incidence of hypotension,bradycardia,nausea and vomiting in the two groups was 9.38%and 35.71%,respectively,with statistically significant differences(P<0.05).Conclusion:Sufentanil combined with ropivacaine has obvious analgesic effect on cesarean section parturients,which can effectively improve the gastrointestinal function of patients.It is safe and effective,and worthy of promotion and application.