[Objectives]This study aimed to investigate the effects of ropivacaine-sufentanil epidural analgesia on labor and maternal and neonatal outcomes.[Methods]A total of 180 primiparas in full-term pregnancy were selected....[Objectives]This study aimed to investigate the effects of ropivacaine-sufentanil epidural analgesia on labor and maternal and neonatal outcomes.[Methods]A total of 180 primiparas in full-term pregnancy were selected.They were randomly divided into treatment group(n=90)and control group(n=90).The primiparas in the treatment group were injected epidurally with ropivacaine and sufentanil for analgesia,and the primiparas in the control group were subjected to vaginal delivery.The VAS scores at 5,10,30 and 60 min of analgesia were observed.The vaginal bleeding amount,total labor duration,neonatal Apgar score and vaginal delivery rate of the two groups were compared.[Results]Compared with the control group,the VAS score in the treatment group differed insignificantly after 5 min of analgesia(P>0.05),and decreased significantly after 10,30 and 60 min of analgesia(P<0.05).The vaginal bleeding amount of the treatment group was significantly smaller than that of the control group(P<0.05).There was no significant difference in the neonatal Apgar score between the two groups(P>0.05).In the treatment group,the vaginal delivery rate increased(P<0.05),the second stage of labor was prolonged(P<0.05),and the first and third stages of labor did not change significantly(P>0.05).[Conclusions]Epidural analgesia with ropivacaine and sufentanil has a good analgesic effect and good safety,and is worthy of clinical promotion.展开更多
目的分析无痛分娩中转为剖宫产麻醉方法选择的影响因素、术中指标和新生儿结局,为产妇提供安全有效的麻醉管理。方法收集2018年1月至2023年7月我院接受无痛分娩中转为剖宫产的单胎初产妇临床资料,根据麻醉方式分为全身麻醉(GA)组、持续...目的分析无痛分娩中转为剖宫产麻醉方法选择的影响因素、术中指标和新生儿结局,为产妇提供安全有效的麻醉管理。方法收集2018年1月至2023年7月我院接受无痛分娩中转为剖宫产的单胎初产妇临床资料,根据麻醉方式分为全身麻醉(GA)组、持续硬膜外麻醉(CEA)组、腰硬联合麻醉(CSEA)组,分析选择不同麻醉方法的影响因素、术中指标及新生儿结局。结果研究共纳入404例中转剖宫产的产妇,中转原因为胎儿宫内窘迫、头盆不称、产程异常、持续性枕横(后)位及社会因素。根据麻醉方法分为GA组39例、CEA组277例、CSEA组88例。CEA组、CSEA组胎儿宫内窘迫占比低于GA组,差异有统计学意义(P<0.05);CSEA组社会因素占比高于CEA组,差异有统计学意义(P<0.05)。CEA组、CSEA组产妇入室至切皮时间长于GA组,且CSEA组长于CEA组,差异有统计学意义(P<0.05);GA组、CEA组产妇术中补液量低于CSEA组,且CEA组低于GA组,差异有统计学意义(P<0.05);GA组、CEA组产妇术中低血压发生率明显低于CSEA组,差异有统计学意义(P<0.05);CEA组与CSEA组比较,CEA组麻醉平面更低、转化GA率及术中镇痛补救率更高、恶心呕吐发生率更低,差异有统计学意义(P<0.05)。新生儿出生后1 min、5 min、10 min Apgar评分差异无统计学意义(P>0.05)。结论无痛分娩中转剖宫产麻醉方法主要采用CEA,其次为CSEA,GA占比最低,3种麻醉方式均不影响新生儿评分;GA在胎儿宫内窘迫等紧急情况下采用更广泛,CEA与CSEA各具特点。展开更多
目的比较腰硬联合麻醉(CSEA)与硬膜外麻醉在分娩镇痛中的应用效果。方法选取2019年1月至2022年3月于上饶东信第五医院分娩的40名产妇作为研究对象,按照随机数字表法分为对照组与观察组,每组20例。对照组实施硬膜外麻醉,观察组实施腰硬...目的比较腰硬联合麻醉(CSEA)与硬膜外麻醉在分娩镇痛中的应用效果。方法选取2019年1月至2022年3月于上饶东信第五医院分娩的40名产妇作为研究对象,按照随机数字表法分为对照组与观察组,每组20例。对照组实施硬膜外麻醉,观察组实施腰硬联合麻醉,比较两组镇痛起效时间、产程(第一产程、第二产程)、应激指标[白细胞介素-6(IL-6)、肾上腺素(ADR)与皮质醇(Cor)、一氧化氮(NO)]、疼痛数字分级法(NRS)评分及镇痛药物用量及自控镇痛次数、产后泌乳指标[泌乳始动时间、产后12h催乳素(PRL)]和泌乳情况及不良反应发生情况。结果观察组镇痛起效时间、第一产程、第二产程均短于对照组,差异有统计学意义(P<0.05)。镇痛5、30min,观察组NRS评分均低于对照组,差异有统计学意义(P<0.05);两组镇痛前后其他时间点NRS评分比较差异无统计学意义。分娩后24h,两组Cor、ADR、IL-6、NO水平均高于产前,但观察组低于对照组,差异有统计学意义(P<0.05)。观察组芬太尼用量、罗哌卡因用量、自控镇痛次数均少于对照组,差异有统计学意义(P<0.05)。观察组泌乳始动时间短于对照组,产后12 h PRL水平、泌乳有效率均高于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论与硬膜外麻醉相比,CSEA用于分娩镇痛中效果良好,可有效缩短产程,缓解患者疼痛感,控制机体应激水平,促进产妇产后泌乳,减少不良反应的发生。展开更多
文摘[Objectives]This study aimed to investigate the effects of ropivacaine-sufentanil epidural analgesia on labor and maternal and neonatal outcomes.[Methods]A total of 180 primiparas in full-term pregnancy were selected.They were randomly divided into treatment group(n=90)and control group(n=90).The primiparas in the treatment group were injected epidurally with ropivacaine and sufentanil for analgesia,and the primiparas in the control group were subjected to vaginal delivery.The VAS scores at 5,10,30 and 60 min of analgesia were observed.The vaginal bleeding amount,total labor duration,neonatal Apgar score and vaginal delivery rate of the two groups were compared.[Results]Compared with the control group,the VAS score in the treatment group differed insignificantly after 5 min of analgesia(P>0.05),and decreased significantly after 10,30 and 60 min of analgesia(P<0.05).The vaginal bleeding amount of the treatment group was significantly smaller than that of the control group(P<0.05).There was no significant difference in the neonatal Apgar score between the two groups(P>0.05).In the treatment group,the vaginal delivery rate increased(P<0.05),the second stage of labor was prolonged(P<0.05),and the first and third stages of labor did not change significantly(P>0.05).[Conclusions]Epidural analgesia with ropivacaine and sufentanil has a good analgesic effect and good safety,and is worthy of clinical promotion.
文摘目的分析无痛分娩中转为剖宫产麻醉方法选择的影响因素、术中指标和新生儿结局,为产妇提供安全有效的麻醉管理。方法收集2018年1月至2023年7月我院接受无痛分娩中转为剖宫产的单胎初产妇临床资料,根据麻醉方式分为全身麻醉(GA)组、持续硬膜外麻醉(CEA)组、腰硬联合麻醉(CSEA)组,分析选择不同麻醉方法的影响因素、术中指标及新生儿结局。结果研究共纳入404例中转剖宫产的产妇,中转原因为胎儿宫内窘迫、头盆不称、产程异常、持续性枕横(后)位及社会因素。根据麻醉方法分为GA组39例、CEA组277例、CSEA组88例。CEA组、CSEA组胎儿宫内窘迫占比低于GA组,差异有统计学意义(P<0.05);CSEA组社会因素占比高于CEA组,差异有统计学意义(P<0.05)。CEA组、CSEA组产妇入室至切皮时间长于GA组,且CSEA组长于CEA组,差异有统计学意义(P<0.05);GA组、CEA组产妇术中补液量低于CSEA组,且CEA组低于GA组,差异有统计学意义(P<0.05);GA组、CEA组产妇术中低血压发生率明显低于CSEA组,差异有统计学意义(P<0.05);CEA组与CSEA组比较,CEA组麻醉平面更低、转化GA率及术中镇痛补救率更高、恶心呕吐发生率更低,差异有统计学意义(P<0.05)。新生儿出生后1 min、5 min、10 min Apgar评分差异无统计学意义(P>0.05)。结论无痛分娩中转剖宫产麻醉方法主要采用CEA,其次为CSEA,GA占比最低,3种麻醉方式均不影响新生儿评分;GA在胎儿宫内窘迫等紧急情况下采用更广泛,CEA与CSEA各具特点。
文摘目的比较腰硬联合麻醉(CSEA)与硬膜外麻醉在分娩镇痛中的应用效果。方法选取2019年1月至2022年3月于上饶东信第五医院分娩的40名产妇作为研究对象,按照随机数字表法分为对照组与观察组,每组20例。对照组实施硬膜外麻醉,观察组实施腰硬联合麻醉,比较两组镇痛起效时间、产程(第一产程、第二产程)、应激指标[白细胞介素-6(IL-6)、肾上腺素(ADR)与皮质醇(Cor)、一氧化氮(NO)]、疼痛数字分级法(NRS)评分及镇痛药物用量及自控镇痛次数、产后泌乳指标[泌乳始动时间、产后12h催乳素(PRL)]和泌乳情况及不良反应发生情况。结果观察组镇痛起效时间、第一产程、第二产程均短于对照组,差异有统计学意义(P<0.05)。镇痛5、30min,观察组NRS评分均低于对照组,差异有统计学意义(P<0.05);两组镇痛前后其他时间点NRS评分比较差异无统计学意义。分娩后24h,两组Cor、ADR、IL-6、NO水平均高于产前,但观察组低于对照组,差异有统计学意义(P<0.05)。观察组芬太尼用量、罗哌卡因用量、自控镇痛次数均少于对照组,差异有统计学意义(P<0.05)。观察组泌乳始动时间短于对照组,产后12 h PRL水平、泌乳有效率均高于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论与硬膜外麻醉相比,CSEA用于分娩镇痛中效果良好,可有效缩短产程,缓解患者疼痛感,控制机体应激水平,促进产妇产后泌乳,减少不良反应的发生。
