罗哌卡因和舒芬太尼腰-硬联合对于分娩镇痛在潜伏期与活跃期效果的比较

Effects of latent phase and active phase labor analgesia with combined spinal-epidural ropivacaine and sufentanil

目的比较罗哌卡因舒芬太尼腰-硬联合分娩镇痛始于潜伏期与活跃期的临床效果。方法将入选的200例足月、单胎分娩的产妇随机分为潜伏期组和活跃期组(每组100例),分别在宫口开至0.5~2.5 cm和3 cm时采用腰-硬联合镇痛。观察镇痛前及产程不同时点视觉模拟(VAS)评分;观察第一产程时间、第二产程时间、分娩方式、缩宫素使用率、新生儿阿氏评分,产妇的运动阻滞程度。采用t检验、卡方检验进行统计学比较。结果两组镇痛前、镇痛后10、30 min(VAS)评分差别无统计学意义;镇痛后宫口扩张7~8 cm、10 cm时VAS评分潜伏组低于活跃组,具有显著差异(P<0.01);第一产程时间、第二产程时间、分娩方式、缩宫素使用率、新生儿阿氏评分,运动阻滞程度差别无统计学意义。结论罗哌卡因舒芬太尼腰-硬联合分娩镇痛始于潜伏期能有效降低母体应激反应,对新生儿无不良反应,较活跃期实施效果更理想,不增加剖宫产率。

Objective To compare the effects of latent phase and active phase of labor analgesia with combined spinal-epidural ropivacaine and sufentanil.Methods The investigation covered 200 full-term,single-birth participants and they were randomized in to latent phase group and active phase group(100 cases each group)and received combined spinal-epidural labor analgesia when their cervices opening 0.5 cm to 2.5 cm,3 cm respectively.VAS before analgesia and during various stages of labor,time for the first stage of labor and the second stage of labor,delivery methods,oxytocin usage,Apgar Score and maternal motor block degree were recorded and analyzed by t test,chi-square test.Results VAS before analgesia and 10 to 30 minutes after analgesia have no significant difference;VAS for the latent phase group was lower than active phase group when cervix opening 7cm to 8 cm,10 cm after analgesia(P<0.01);Time length for the first and the second stage of labor,delivery way,oxytocin usage,Apgar Score and maternal motor block degree were similar.Conclusions It is feasible and safe to treat latent phase labor analgesia with combined spinal-epidural ropivacaine and sufentanil.