浓度递增法程控硬膜外间歇脉冲注入罗哌卡因对产妇不同时间的镇痛效果影响分析

Analysis of the Effect of Concentration Increasing Method on the Analgesic Effect of Epidural Intermittent Pulse Injection of Ropivacaine in Parturients at Different Times

目的:探讨浓度递增法程控硬膜外间歇脉冲注入(PIEB)罗哌卡因对产妇不同时间的镇痛效果影响。方法:选取2021年1月—2023年1月福建医科大学附属漳州市医院收治的140例足月妊娠初产妇作为研究对象,按照随机数表法分为对照组(n=69)和观察组(n=71),两组均采用PIEB给予罗哌卡因,其中对照组给予固定浓度进行分娩镇痛,观察组给予浓度递增法进行分娩镇痛。观察两组不同时间的疼痛程度、镇痛药物消耗情况、爆发疼痛情况、不良反应发生情况。结果:观察组宫口全开后15 min及分娩时视觉模拟量表(VAS)评分均较对照组低,差异有统计学意义(P<0.05);观察组罗哌卡因总药量、舒芬太尼总药量均较对照组少,硬膜外自控镇痛(PCEA)按压次数较对照组低,差异有统计学意义(P<0.05);观察组爆发痛发生率(5.63%)较对照组(15.94%)低,追加镇痛药物次数较对照组少,差异有统计学意义(P<0.05);观察组不良反应发生率(16.90%)低于对照组(31.88%),差异有统计学意义(P<0.05)。结论:初产妇分娩镇痛采用浓度递增法PIEB注入罗哌卡因具有较好的镇痛效果,且疼痛爆发情况较少,并减少疼痛药物用量及不良反应。

Objective:Exploring the analgesic effect of concentration increasing method controlled epidural intermittent pulse injection of ropivacaine on parturients at different times.Method:A total of 140 first-time parturients with full-term pregnancy admitted to Zhangzhou Hospital of Fujian Medical University from January 2021 to January 2023 were selected as study objects and divided into control group(n=69)and observation group(n=71)according to random number table method.Both groups were given ropivacaine by PIEB.The control group was given labor analgesia with fixed concentration,while the observation group was given labor analgesia by concentration increment method.The pain degree,analgesic drug consumption,pain outbreak and adverse reactions of the two groups were observed at different times.Result:The VAS scores in observation group were lower than those in control group 15 min after full uterine opening and delivery,and the difference was statistically significant(P<0.05).The total dose of ropivacaine and sufentanil in observation group were lower than those in control group,and the patient controlled Epidural analgesia(PCEA)press times were lower than those in control group,the difference was statistically significant(P<0.05).The incidence of pain outbreak in the observation group was 5.63%,which was lower than 15.94%in the control group,and the number of additional analgesic drugs was less than that in the control group,the difference was statistically significant(P<0.05).The incidence of adverse reactions in observation group was 16.90%,which was lower than 31.88%in control group,and the difference was statistically significant(P<0.05).Conclusion:The use of concentration increasing method for programmed epidural intermittent pulse injection of ropivacaine for pain relief in primiparous women during childbirth has a good analgesic effect,with fewer pain outbreaks and reduced dosage of pain medication and adverse reactions.