论文部分内容阅读
目的评价低浓度罗哌卡因配伍小剂量舒芬太尼及芬太尼用于硬膜外自控分娩镇痛的效果。方法产科自愿接受分娩镇痛、经阴道分娩的初产妇60例随机均分为两组,SF组硬膜外镇痛采用0.08%罗哌卡因+舒芬太尼0.4μg/ml,F组采用0.08%罗哌卡因+芬太尼2μg/ml,均加入生理盐水共100ml。连续监测分娩过程中产妇的血压、心率、呼吸、宫缩及胎心情况,分别在镇痛前、镇痛后10min、30min、宫口开全、缝合会阴时进行VAS疼痛评分,记录活跃期、第二、三产程时间、宫缩情况、胎心率、分娩方式、催产素使用率、产后出血量、胎儿娩出后1-min、5-min Apgar评分,观察下肢运动阻滞情况及不良反应。结果两组产妇在镇痛前、镇痛后、宫口开全、缝合会阴时的VAS评分差异均无统计学意义(P>0.05)。SF组活跃期较F组缩短(P<0.05);SF组在镇痛过程中可出现宫缩减弱,第二、三产程时间较F组略长,但差异无统计学意义(P>0.05)。两组催产素使用率、剖宫产率、阴道助产率、产后出血率和新生儿窒息率差异均无统计学意义(P>0.05)。结论低浓度罗哌卡因配伍小剂量舒芬太尼用于硬膜外自控分娩镇痛效果确切,可缩短产程,对母婴无不良影响。
Objective To evaluate the effect of low concentration of ropivacaine combined with low dose sufentanil and fentanyl for epidural self-controlled labor analgesia. Methods A total of 60 primiparae women who received labor analgesia and vaginal delivery voluntarily were randomly divided into two groups. The epidural analgesia in group SF was treated with 0.08% ropivacaine plus sufentanil 0.4μg / ml, while in group F, 0.08% ropivacaine + fentanyl 2μg / ml, were added to a total of 100ml of normal saline. Continuous monitoring of maternal blood pressure, heart rate, respiration, uterine contractions and fetal heart rate during labor, VAS pain scores were recorded before analgesia, 10 min after analgesia, 30 min, Second and third stage of labor, contractions, fetal heart rate, mode of delivery, oxytocin use rate, postpartum hemorrhage, 1-min, 5-min Apgar score after delivery, and observed the lower extremity motion block and adverse reactions. Results There was no significant difference in VAS score between the two groups before analgesia, analgesia, cervix opening and suturing perineum (P> 0.05). The active phase of SF group was shorter than that of F group (P <0.05). The duration of second and third stage of labor in SF group was slightly longer than that in F group, but the difference was not statistically significant (P> 0.05) . There were no significant differences in the rates of oxytocin use, cesarean section rate, vaginal delivery rate, postpartum hemorrhage rate and neonatal asphyxia (P> 0.05). Conclusion Low concentration of ropivacaine combined with low-dose sufentanil for epidural delivery with controlled analgesia is effective, which can shorten the labor process and has no adverse effect on maternal and infant.