低剂量罗哌卡因复合舒芬太尼腰硬联合麻醉在无痛分娩中的应用价值

Application value of low-dose ropivacaine combined with sufentanil for combined spinal epidural anesthesia in painless labor

目的探讨低剂量罗哌卡因复合舒芬太尼腰硬联合麻醉在无痛分娩中的应用价值。方法将2018年10月至2019年10月在我院进行无痛分娩的126例产妇随机分为观察组和对照组,每组63例。两组均采用低剂量罗哌卡因复合舒芬太尼麻醉,对照组给予硬膜外麻醉(EA),观察组给予腰硬联合麻醉(CSEA)。比较两组的应激反应、泌乳功能及分娩结局。结果分娩活跃期,两组Cor水平均升高,NO水平均降低,但观察组优于对照组(P<0.05)。观察组泌乳始动时间短于对照组,泌乳有效率高于对照组(P<0.05)。两组的中转剖宫产率、产钳使用率、会阴侧切率及新生儿出生1、5 min Apgar评分均无显著差异(P>0.05)。结论低剂量罗哌卡因复合舒芬太尼CSEA应用于无痛分娩中可有效减轻产妇应激反应,提高泌乳功能,保证母婴安全。

Objective To explore the application value of low-dose ropivacaine combined with sufentanil for combined spinal epidural anesthesia in painless labor.Methods A total of 126 cases of parturients undergoing painless labor in our hospital from October 2018 to October 2019 were randomly divided into observation group and control group,with 63 cases in each group.Both groups were given low-dose ropivacaine combined with sufentanil anesthesia,the control group was given epidural anesthesia(EA),and the observation group was given combined spinal epidural anesthesia(CSEA).The stress response,lactation function and delivery outcomes of the two groups were compared.Results In the active stage of labor,the levels of Cor in both groups increased,the levels of NO decreased,but those in the observation group were better than the control group(P<0.05).The lactation initiation time of the observation group was shorter than that of the control group,and the effective rate of lactation was higher than that of the control group(P<0.05).There were no significant differences in the rates of conversion to cesarean section,usage rate of forceps,lateral episiotomy rate and Apgar scores at 1 and 5 min after birth between the two groups(P>0.05).Conclusion Low dose ropivacaine combined with sufentanil for CSEA in painless labor can effectively reduce stress response of parturients,improve lactation function,and ensure the safety of mother and infant.