右美托咪定复合罗哌卡因硬膜外麻醉在无痛分娩中的应用效果

Practical effect of dexmedetomidine combined with ropivacaine epidural anesthesia in painless labor

目的探讨右美托咪定复合罗哌卡因硬膜外麻醉在无痛分娩的应用效果。方法300例行阴道分娩的产妇,随机分为观察组和对照组,每组150例。对照组行罗哌卡因硬膜外麻醉,观察组行右美托咪定复合罗哌卡因硬膜外麻醉。比较两组视觉模拟评分法(VAS)评分、产程时间以及不良事件发生情况。结果镇痛后10、30、60 min,两组产妇VAS评分均低于镇痛前,且观察组镇痛后10、30、60 min的VAS评分分别为(5.15±0.48)、(3.76±0.37)、(2.37±0.29)分,均低于对照组的(6.07±0.50)、(4.34±0.42)、(3.12±0.33)分,差异有统计学意义(P<0.05)。观察组产妇的第一产程、第二产程和第三产程时间分别为(312.54±26.43)、(42.65±5.43)、(8.24±1.05)min,均短于对照组的(340.42±27.58)、(57.14±6.30)、(9.02±1.24)min,差异有统计学意义(P<0.05)。观察组不良事件发生率为6.67%,与对照组的8.67%比较,差异无统计学意义(P>0.05)。结论右美托咪定复合罗哌卡因硬膜外麻醉在分娩镇痛中效果显著,有利于缩短产程,并且临床安全性较高。

Objective To discuss the practical effect of dexmedetomidine combined with ropivacaine epidural anesthesia in painless labor.Methods A total of 300 pregnant women undergoing vaginal delivery were randomly divided into observation group and control group,with 150 cases in each group.The control group received ropivacaine epidural anesthesia,and the observation group received dexmedetomidine combined with ropivacaine epidural anesthesia.The visual analogue scale(VAS)score,duration of labor and occurrence of adverse events were compared between the two groups.Results 10,30 and 60 min after analgesia,the VAS score of the two groups were lower than those before analgesia;the VAS score 10,30 and 60 min after analgesia of the observation group were(5.15±0.48),(3.76±0.37),(2.37±0.29)points,which were(6.07±0.50),(4.34±0.42),(3.12±0.33)points of the control group.All the difference was statistically significant(P<0.05).The time of the first,second and third stages of labor of the observation group were(312.54±26.43),(42.65±5.43)and(8.24±1.05)min,which were shorter than(340.42±27.58),(57.14±6.30)and(9.02±1.24)min of the control group,and the difference was statistically significant(P<0.05).The incidence of adverse events of the observation group was 6.67%,which had no statistically significant difference compared with 8.67%of the control group(P>0.05).Conclusion Combination of dexmedetomidine and ropivacaine epidural anesthesia has remarkable effect in painless labor,and it helps shorten the labor process and has high clinical safety.