蛛网膜下腔单次注入舒芬太尼联合罗哌卡因+舒芬太尼腰硬联合阻滞在分娩镇痛中的应用价值

Application value of single subarachnoid injection of sufentanil combined with ropivacaine+sufentanil combined spinal-epidural block in labor analgesia

目的探究蛛网膜下腔单次注入舒芬太尼联合罗哌卡因+舒芬太尼腰硬联合阻滞在分娩镇痛中的应用价值。方法选择2020年3月至2023年3月收治的80例分娩镇痛产妇为研究对象,以随机数字表法将其分为对照组、观察组,每组40例。对照组接受罗哌卡因+舒芬太尼腰硬联合阻滞,观察组在对照组基础上加施蛛网膜下腔单次注入舒芬太尼。比较两组的应激反应指标、疼痛程度、新生儿出生质量以及母婴安全情况。结果麻醉后15 min、分娩后2 h,观察组的促肾上腺皮质激素(ACTH)、促肾上腺皮质激素释放素(CRH)、皮质醇(Cor)水平均低于对照组(P<0.05)。观察组第一产程、第二产程、第三产程的视觉模拟评分法(VAS)评分均低于对照组(P<0.05)。观察组的中转剖宫产发生率低于对照组(P<0.05)。结论蛛网膜下腔单次注入舒芬太尼联合罗哌卡因+舒芬太尼腰硬联合阻滞用于分娩镇痛中,可缓解产妇不同时间段的疼痛情况及应激反应,降低中转剖宫产发生率,且保障了母婴安全。

Objective To explore the application value of single subarachnoid injection of sufentanil combined with ropivacaine+sufentanil combined spinal-epidural block in labor analgesia.Methods A total of 80 parturients with labor analgesia admitted from March 2020 to March 2023 were selected as the research objects and divided into control group and observation group by random number table method,with 40 cases in each group.The control group received ropivacaine+sufentanil combined spinal-epidural block,and the observation group received single subarachnoid injection of sufentanil on the basis of the control group.The stress response indicators,pain degree,neonatal birth quality and safety of mothers and infants of the two groups were compared.Results At 15 min after anesthesia and 2 h after delivery,the levels of adrenocorticotrophic hormone(ACTH),corticotropin releasing hormone(CRH)and cortisol(Cor)in the observation group were lower than those in the control group(P<0.05).The Visual Analogue Scale(VAS)scores of the first,second and third stages of labor in the observation group were lower than those in the control group(P<0.05).The incidence of conversion to cesarean section in the observation group was lower than that in the control group(P<0.05).Conclusion Single subarachnoid injection of sufentanil combined with ropivacaine+sufentanil combined spinal-epidural block for labor analgesia can alleviate the pain and stress response of parturients at different time periods,reduce the incidence of conversion to cesarean section,and ensure the safety of mothers and infants.