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目的探讨两种不同浓度的舒芬太尼配伍0.10%罗哌卡因对硬膜外分娩镇痛效果的影响。方法选择年龄18~40岁,美国麻醉医师协会(ASA)麻醉风险分级Ⅰ~Ⅱ级的足月自然分娩的孕妇,入选患者均接受硬膜外分娩镇痛方案,采用随机双盲的方法,分为低浓度舒芬太尼组(A组,0.25μg/ml舒芬太尼+0.10%罗哌卡因)和高浓度舒芬太尼组(B组,0.50μg/ml舒芬太尼+0.10%罗哌卡因)。观察单次给药后最高镇痛平面、运动阻滞程度、无痛分娩期间不同时点的视觉模拟评分(VAS),产程时间;新生儿出生后1、5、10 min时Apgar评分及瘙痒、恶心、呕吐等不良反应,最后记录麻醉药物使用总量。结果共纳入120例患者,每组60例。2组患者在单次给药后的最高镇痛平面及各时点的VAS评分,新生儿出生后1、5、10分钟时Apgar评分差异无统计学意义(P>0.05),2组患者无瘙痒、呕吐并发症,2组患者运动阻滞程度、不良反应、无痛分娩满意度差异无统计学意义(P>0.05)。但A组患者的第一产程和第三产程时间明显短于B组患者(P<0.05),A组舒芬太尼总量明显低于B组(P<0.05)。结论 0.25μg/ml舒芬太尼+0.10%罗哌卡因可提供满意的硬膜外痛分娩镇痛效果,运动阻滞少,程度轻,安全,不良反应偶发,第一产程明显缩短。
Objective To investigate the effects of sufentanil combined with 0.10% ropivacaine on the analgesia of epidural delivery. Methods Pregnant women, aged from 18 to 40 years with full-term spontaneous delivery of ASA Anesthesia Risk Class Ⅰ-Ⅱ, were enrolled in this study. Patients were enrolled in the epidural analgesia program. Randomized double-blind Were low-dose sufentanil (group A, 0.25 μg / ml sufentanil and 0.10% ropivacaine) and high-concentration sufentanil (group B, 0.50 μg / ml sufentanil + 0.10 % Ropivacaine). Visual acuity score (VAS) and labor duration at different time points after painless delivery were observed; Apgar score and pruritus at 1, 5 and 10 min after birth were observed, Nausea, vomiting and other adverse reactions, and finally record the total amount of narcotic drugs. Results A total of 120 patients were included, 60 cases in each group. There was no significant difference in Apgar score between the two groups at the highest analgesic level and at each time point after single-dose administration. There was no significant difference in Apgar scores at 1, 5 and 10 minutes after birth (P> 0.05) Pruritus and vomiting complication. There was no significant difference in degree of motor block, adverse reaction and painless childbirth between the two groups (P> 0.05). However, the duration of the first stage of labor and the third stage of labor in group A was significantly shorter than that in group B (P <0.05). The total sufentanil in group A was significantly lower than that in group B (P <0.05). Conclusions 0.25μg / ml sufentanil + 0.10% ropivacaine can provide satisfactory analgesia effect of epidural analgesia with little motor block, lightness, safety and sporadic adverse reactions. The first birth process is significantly shortened.