低浓度罗哌卡因复合舒芬太尼硬膜外注射用于分娩镇痛对产妇产间发热的影响

The Effect of Epidural Injection of Low Concentration Ropivacaine Combined with Sufentanil for Labor Analgesia on Interpartum Fever

目的探讨低浓度罗哌卡因复合舒芬太尼硬膜外注射用于分娩镇痛对产妇产间发热的影响。方法选取2019年5月—2020年8月于该院分娩的68名健康产妇,按照随机数表法分为对照组和研究组,每组34名。研究组予以0.075%罗哌卡因复合舒芬太尼镇痛,对照组予以0.125%罗哌卡因复合舒芬太尼镇痛。比较两组产妇镇痛前后的发热率和镇痛前(T0)、镇痛后1、3、5 h(T1~T3)、胎儿娩出时(T4)、分娩后2 h(T5)的体温和镇痛前、胎儿娩出时、分娩后2 h的血清白细胞介素-6(IL-6)、白细胞介素-1(IL-1)、肿瘤坏死因子(TNF-α)水平。结果研究组产妇镇痛后发热率(11.76%)明显低于对照组(32.35%),差异有统计学意义(χ^(2)=4.191,P<0.05)。研究组T2、T3时的体温(36.5±0.36)℃、(36.6±0.33)℃显著低于对照组,差异有统计学意义(t=2.079、3.153,P<0.05);胎儿娩出时,研究组产妇血清IL-6、IL-1、TNF-α的水平均低于对照组,差异有统计学意义(P<0.05)。结论低浓度罗哌卡因复合舒芬太尼用于产妇分娩镇痛可降低镇痛后发热率并改善产间发热情况,这与致热因子的浓度降低有关。

Objective To explore the effect of epidural injection of low-concentration ropivacaine combined with sufentanil for labor analgesia on interpartum fever.Methods A selection of 68 healthy parturients who gave birth in the hospital from May 2019 to August 2020 were divided into a control group and a study group according to a random number table,with 34 pootients in each group.The study group received 0.075%ropivacaine combined with sufentanil for analgesia,and the control group received 0.125%ropivacaine combined with sufentanil for analgesia.The fever rate before and after analgesia and the body temperature before analgesia(T0),1 h,3 h,5 h after analgesia(T1-T3),fetal delivery(T4),and 2 h(T5)after delivery were compared between the two groups and serum interleukin 6(IL-6),interleukin 1(IL-1),tumor necrosis factor(TNF-α)levels before analgesia,when the fetus was delivered,and 2 h after delivery.Results The fever rate after analgesia in the study group(11.76%)was significantly lower than that in the control group(32.35%),and the difference was statistically significant(χ^(2)=4.191,P<0.05).The body temperature(36.5±0.36)℃and(36.6±0.33)℃of the study group at T2 and T3 were significantly lower than those of the control group,and the difference was statistically significant(t=2.079,3.153,P<0.05).And when the fetus was delivered,the maternal serum levels of IL-6,IL-1 and TNF-αin the study group were lower than those in the control group,and the difference was statistically significant(P<0.05).Conclusion Low-concentration ropivacaine combined with sufentanil for analgesia during childbirth can reduce the fever rate after analgesia and improve interpartum fever,which is related to the decrease in the concentration of pyrogenic factors.