罗哌卡因联合舒芬太尼硬膜外自控镇痛法用于高龄产妇无痛分娩的效果及对产后出血量的影响

Effect of controlled epidural analgesia of ropivacaine combined with sufentanil on painless delivery in elderly women and its effect on postpartum hemorrhage

目的:探讨联用盐酸罗哌卡因和枸椽酸舒芬太尼对进行无痛分娩的高龄产妇实施硬膜外自控镇痛的临床效果及对其产后出血量的影响。方法:将2019年6月至2021年3月在徐闻县人民医院和徐闻妇幼保健院进行无痛分娩的90例高龄产妇随机分为对照组(45例)和观察组(45例)。应用盐酸罗哌卡因对对照组产妇进行硬膜外自控镇痛。联用盐酸罗哌卡因和枸椽酸舒芬太尼对观察组产妇进行硬膜外自控镇痛。然后,比较两组产妇的镇痛效果、产后出血量、产程时间及产后功能性障碍的发生情况。结果:观察组产妇镇痛的总有效率高于对照组产妇,P<0.05。产后24 h,观察组产妇的出血量少于对照组产妇,P<0.05。观察组产妇第一产程、第二产程及第三产程的时间均短于对照组产妇,P<0.05。观察组产妇产后功能性障碍的总发生率低于对照组产妇,P<0.05。结论:联用盐酸罗哌卡因和枸椽酸舒芬太尼对进行无痛分娩的高龄产妇实施硬膜外自控镇痛的效果较好,可减少其产后24 h的出血量,缩短其产程,减少其产后功能性障碍的发生。

Objective:To investigate the clinical effect of combined administration of ropivacaine hydrochloride and sufentanil citrate on epidural self-control analgesia in elderly parturient women undergoing painless delivery and its influence on postpartum blood loss.METHODS:A total of 90 elderly parurai who underwent painless delivery in Xuwen County People's Hospital and Xuwen Maternal and Child Health Hospital from June 2019 to March 2021 were randomly divided into control group(45 cases)and observation group(45 cases).Ropivacaine hydrochloride was applied to control group for epidural automatic analgesia.Combined with ropivacaine hydrochloride and sufentanil citrate,epidural automatic analgesia was performed in the observation group.Then,the analgesic effect,postpartum blood loss,labor duration and the occurrence of postpartum dysfunction were compared between the two groups.Results:The total effective rate of analgesia in observation group was higher than that in control group(P<0.05).24 h postpartum,the maternal blood loss in the observation group was less than that in the control group,P<0.05.The time of the first stage of labor,the second stage of labor and the third stage of labor in the observation group were all shorter than those in the control group(P<0.05).The total incidence of postpartum dysfunction in observation group was lower than that in control group(P<0.05).Conclusion:The combined administration of ropivacaine hydrochloride and sufentanil citrate has a good effect on the epidural self-control analgesia for the elderly parturients undergoing painless delivery,which can reduce the postpartum 24 h blood loss,shorten the labor process,and reduce the occurrence of postpartum functional disorders.