0.2%罗哌卡因复合芬太尼维持在产妇硬膜外分娩镇痛中的应用效果

Application of 0.2%Ropivacaine+Fentanyl Maintenance in Epidural Labor Analgesia

目的:探究0.2%罗哌卡因复合芬太尼维持麻醉在产妇硬膜外分娩镇痛中的应用价值。方法:选择2020年1月—2021年12月于我院分娩的足月、单胎、头位80例产妇作为研究对象,按照随机数字表法将其分为A组(麻醉维持为0.2%罗哌卡因+2 mg/L芬太尼)和B组(麻醉维持为0.125%罗哌卡因+2 mg/L芬太尼),比较两组产妇各产程疼痛度、产程时间、不同时间点血流动力学指标,以及分娩方式、使用缩宫素及产后出血情况,并统计两组新生儿Apgar评分以及胎心异常情况;结果:A组产妇第一产程和第二产程VAS评分均低于B组,差异有统计学意义(P<0.05);两组产妇第一产程、第二产程、第三产程时间比较,差异无统计学意义(P>0.05);A组用药后MAP与HR均低于B组,差异有统计学意义(P<0.05);两组分娩方式以及产后出血率比较,差异无统计学意义(P>0.05);A组产妇使用缩宫素占比高于B组,差异有统计学意义(P<0.05);两组新生儿1 min和5 min时Apgar评分及胎心异常发生率比较,差异无统计学意义(P>0.05)。结论:0.2%罗哌卡因复合芬太尼维持麻醉在产妇硬膜外分娩镇痛中应用效果较好,可以有效稳定产妇的心率血压,同时对胎儿不会产生明显的影响。

Objective:To explore the application value of 0.2%ropivacaine combined with fentanyl in maternal epidural labor analgesia.Methods:A total of 80 full-term,singleton and head position parturients delivered in our hospital from January 2020 to December 2021 were selected as the research objects.They were randomly divided into group A(anesthesia maintenance of 0.2%ropivacaine+2 mg/L fentanyl)and group B(anesthesia maintenance of 0.125%ropivacaine+2 mg/L fentanyl).The pain degree,duration of labor Hemodynamic indexes,delivery mode,oxytocin use and postpartum hemorrhage at different time points,and the differences of neonatal Apgar score and fetal heart rate abnormalities between the two groups were counted.Results:The VAS scores of the first and second stages of labor in group A were lower than those in group B,and the difference was statistically significant(P<0.05).There was no significant difference in the first stage of labor,the second stage of labor and the third stage of labor between the two groups(P>0.05).MAP and HR in group A were lower than those in group B after medication,and the difference was statistically significant(P<0.05).There was no significant difference in delivery mode and postpartum hemorrhage rate between the two groups(P>0.05).The proportion of oxytocin in group A was higher than that in group B,and the difference was statistically significant(P<0.05).There was no significant difference in Apgar score and incidence of fetal heart abnormalities between the two groups at 1 min and 5 min(P>0.05).Conclusion:The application effect of 0.2%ropivacaine combined with fentanyl maintenance anesthesia in maternal epidural labor analgesia is good,which can effectively stabilize maternal heart rate and blood pressure,and has no significant effect on the fetus.