纳布啡联合罗哌卡因对产妇硬膜外分娩镇痛的影响

The effect of epidural analgesia with nalbuphine combined with ropivacaine on labor pain

目的探讨硬膜外纳布啡联合罗哌卡因对产妇硬膜外分娩镇痛的影响。方法选取2019年2月至2021年2月在该院进行分娩镇痛的产妇80例,依照随机数字表法将其分为对照组和观察组,每组40例。对照组接受舒芬太尼联合罗哌卡因自控硬膜外镇痛,观察组接受纳布啡联合罗哌卡因自控硬膜外镇痛。比较两组镇痛起效时间、首次应用患者自控镇痛(PCA)时间、PCA按压次数、罗哌卡因消耗量及两组不同时间镇痛效果、生命体征及首次泌乳时间、出血量、不良反应的发生情况。结果观察组镇痛起效时间、首次应用PCA时间短于对照组,PCA按压次数、罗哌卡因消耗量多于对照组,差异有统计学意义(P<0.05);T3时观察组视觉模拟评分高于对照组,差异有统计学意义(P<0.05)。与T0~T4时比,T5时两组脉搏血氧饱和度水平升高,差异有统计学意义(P<0.05);观察组首次泌乳时间、出血量、不良反应与对照组比较,差异无统计学意义(P>0.05)。结论纳布啡联合罗哌卡因在分娩硬膜外镇痛中起效时间快,可延长PCA时间,安全可靠,但宫口全开时疼痛剧烈,麻醉药物消耗量大。

Objective To investigate the effect of epidural analgesia with nalbuphine combined with ropivacaine on labor analgesia.Methods A total of 80 puerpera who underwent labor analgesia in the hospital from February 2019 to February 2021 were selected and divided into control group and observation group according to the random number table method,with 40 cases in each group.The control group received sufentanil combined with ropivacaine controlled epidural anesthesia,the observation group received nalbuphine combined ropivacaine controlled epidural anesthesia.The time of onset of analgesia,the first patient-controlled analgesia(PCA)application,the times of PCA pressing and the consumption of ropivacaine were compared between the two group,the analgesic effect,vital signs,first lactation time,bleeding volume and adverse reactions were compared between the two groups.Results The analgesic onset time and the first application of PCA in the observation group were shorter than those in the control group,and the times of PCA pressing and ropivacaine consumption were more than those in the control group,and the differences were statistically significant(P<0.05).At T3,the visual analogue score in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Compared with T0-T4,SpO 2 levels in the two groups were increased at T5,and the difference was statistically significant(P<0.05).There were no significant differences in the first lactation time,bleeding volume and adverse reactions between the observation group and the control group(P>0.05).Conclusion Nalbuphine can prolong the time of patient-controlled epidural Analgesia,and it is safe and reliable,but the pain is severe when the cervix is fully opened,and the consumption of anesthetic drugs is large.