纳布啡复合罗哌卡因用于硬膜外自控分娩镇痛的效果

Effect of Nalbuphine Combined with Ropivacaine on Epidural Patient-controlled Labor Analgesia

目的:探析纳布啡复合罗哌卡因在硬膜外自控分娩镇痛中的应用效果。方法:选取2021年4-7月于潮州市妇幼保健院采用硬膜外自控镇痛(PCEA)分娩的孕妇200例作为研究对象,按计算机分组法将其随机分为研究组和对照组,每组100例。对照组实施常规镇痛(罗哌卡因+舒芬太尼),研究组采用纳布啡+罗哌卡因镇痛。记录两组实施镇痛前(T_(0))、镇痛10 min(T_(1))、镇痛30 min(T_(2))、宫口全开(T_(3))、分娩后(T_(4))的疼痛视觉模拟评分法(VAS)评分变化情况,术后采用Ramsay镇静评分评估产妇的镇静情况,采用Apgar评分评估胎儿娩出5 min后的身体状况,统计两组术后的不良反应发生情况。结果:研究组T_(1)、T_(2)、T_(3)、T_(4)的VAS评分均低于对照组,术后Ramsay镇静评分高于对照组,胎儿娩出5 min后的Apgar评分高于对照组,术后不良反应发生率[8.00%(8/100)]低于对照组[20.00%(20/100)],差异均有统计学意义(P<0.05)。结论:将纳布啡+罗哌卡因用于PCEA分娩中可显著改善产妇分娩过程中的疼痛情况,经二者联合用药后产妇产后镇静情况及新生儿生存情况较佳,且此镇痛方案不会导致产妇发生严重不良反应,其有效性及安全性均较高,建议可在临床中进一步推广应用。

Objective:To explore the application effect of Nalbuphine combined with Ropivacaine in epidural patient-controlled labor analgesia.Method:A total of 200 pregnant women who underwent patient-controlled epidural analgesia(PCEA)during their delivery from April to July 2021 in Chaozhou Maternal and Child Health Hospital were selected as the research subjects and randomly divided into the study group and the control group according to the computer grouping method,with 100 cases in each group.The control group received conventional analgesia(Ropivacaine+Sufentanil),and the study group used Nalbuphine+Ropivacaine for analgesia.The changes of pain visual analogue scale(VAS)scores before analgesia(T_(0)),10 min after analgesia(T_(1)),30 min after analgesia(T_(2)),full opening of the orifice of the uterus(T_(3))and after delivery(T_(4))in the two groups were recorded.The sedation of the parturients was assessed by Ramsay sedation score after operation,and the survival of the fetus after 5 min of delivery was assessed by Apgar score.The adverse reactions postoperative in the two groups were counted.Result:The VAS scores of T_(1),T_(2),T_(3)and T_(4)in the study group were lower than those in the control group,the postoperative Ramsay scores was higher than that of the control group,the Apgar score 5 min after delivery of the fetus was higher than that of the control group,and the incidence of adverse reactions postoperative[8.00%(8/100)]was lower than 20.00%(20/100)of the control group,the differences were statistically significant(P<0.05).Conclusion:The use of Nalbuphine+Ropivacaine in PCEA delivery can significantly improve the pain in the parturients during delivery.After the combined use of the two drugs,the parturients’postpartum sedation and neonatal survival are better.In addition,this analgesic plan will not cause serious adverse reactions of the parturients.The effectiveness and safety are both high,and it is recommended that the analgesic plan be further applied in clinical practice.