不同时机应用罗哌卡因联合舒芬太尼镇痛的效果和对分娩结局的影响

Effects of Ropivacaine combined with Sufentanil analgesia at different times on delivery outcomes

目的:比较不同时机应用罗哌卡因联合舒芬太尼进行镇痛的效果和对分娩结局的影响。方法:选取100例自然分娩的产妇为研究对象,按随机数字表法分为观察组与对照组各50例,观察组在潜伏期(开始出现规律宫缩至宫口扩张至3 cm)给予罗哌卡因联合舒芬太尼镇痛,对照组在活跃期(宫口扩张3 cm至宫口开全)给予罗哌卡因联合舒芬太尼镇痛,比较两组镇痛效果、产妇生命体征及分娩结局。结果:两组宫口开至1 cm及宫口全开时VAS评分比较差异无统计学意义(P>0.05),观察组宫口开至2 cm、3 cm时VAS评分显著低于对照组,差异有统计学意义(P<0.05);麻醉后30 min,两组心率、呼吸频率及平均动脉压较麻醉前明显降低,差异有统计学意义(P<0.05),但两组组间比较,差异无统计学意义(P>0.05);两组麻醉前和麻醉后30 min血氧饱和度比较,差异均无统计学意义(P>0.05);两组潜伏期、第一产程时间、第二产程时间、第三产程时间比较,差异无统计学意义(P>0.05);两组新生儿Apgar评分比较,差异无统计学意义(P>0.05);两组产妇自然分娩、转剖宫产及助产率比较,差异无统计学意义(P>0.05)。结论:在产妇分娩潜伏期给予其罗哌卡因联合舒芬太尼镇痛,可有效减轻潜伏期疼痛程度,且对产妇生命体征、分娩方式及新生儿无明显影响。

Objective: To compare effects of Ropivacaine combined with Sufentanil analgesia at different times on delivery outcomes. Methods: 100 natural delivery women were selected as the research objects, and were divided into observation group and control group according to random number table method, 50 cases in each. The observation group was given Ropivacaine combined with Sufentanil analgesia during the incubation period(regular contractions began to cervix dilated to 2-3 cm), while the control group was given Ropivacaine combined with Sufentanil analgesia during the active period(cervix dilated to 3 cm to uterine full opening). Then, the analgesic effects, maternal vital signs and delivery outcomes were compared between the two groups. Results: There was no significant difference in the VAS score between the two groups when the cervix was dilated to 1 cm and the cervix was fully open(P>0.05). The VAS scores of the observation group were significantly lower than those of the control group when the cervix was dilated to 2 cm and 3 cm, and the differences were statistically significant(P<0.05). 30 minutes after anesthesia, the heart rates, respiratory rates and average pulse pressure of the two groups were significantly lower than those before the anesthesia, and the difference was statistically significant(P<0.05);however, the difference between the two groups was not statistically significant(P>0.05). There was no statistically significant difference in the blood oxygen saturation between the two groups before and 30 minutes after anesthesia(P>0.05). There were no significant differences between the two groups in the incubation period, time of first stage of labor, time of second stage of labor and time of third stage of labor(P>0.05). There was no significant difference in the Apgar score between the two groups(P>0.05). Further, there was no statistically significant difference in the rate of spontaneous delivery, cesarean section and assisted delivery between the two groups(P> 0.05). Conclusions: Ropivacaine combined with Sufentanil analgesia during the incubation period can effectively reduce the degree of pain in the incubation period, and has no significant effects on the maternal vital signs, delivery modes and newborns.