低浓度罗哌卡因复合小剂量舒芬太尼椎管内分娩镇痛在剖宫产术后再次妊娠阴道分娩中的应用  

Low concentration of ropivacaine combined with small dose of sufentanil used in intrathecal labor analgesia in vaginal birth after cesarean section

作　　者：陈秀斌[1] 周健[2] 单震丽[2] 刘铭[2] 周木兰[2] 刘志强[1] 

机构地区：[1]同济大学附属第一妇婴保健院麻醉科,上海200040 [2]同济大学附属第一妇婴保健院产科,上海200040

出　　处：《现代妇产科进展》2014年第10期804-806,共3页Progress in Obstetrics and Gynecology

基　　金：上海申康医院发展中心;市级医院适宜技术联合开发推广应用项目(No:SHDC12010208)

摘　　要：目的:探讨低浓度罗哌卡因复合小剂量舒芬太尼椎管内分娩镇痛用于剖宫产术后再次妊娠阴道分娩(VBAC)的可行性。方法:回顾分析2012年1月至2013年12月于我院建卡的剖宫产术后再次妊娠要求阴道试产的单胎、足月病例83例,按是否接受椎管内分娩镇痛将研究对象分为镇痛组(37例)和非镇痛组(46例)。比较两组的产程时间、催产素使用情况、分娩方式、产后出血量、新生儿体重及新生儿Apgar评分。结果:两组产妇的年龄、体重指数、孕周比较,差异均无统计学意义。镇痛组的催产素使用率为62.2%,显著高于非镇痛组(21.7%)(P<0.01)。镇痛组镇痛后的VAS评分显著低于镇痛前[(9.43±0.50)分vs(3.16±0.69)分,P<0.01]。两组的产程时间、产后出血量、新生儿体重、Apgar评分比较,差异无统计学意义(P>0.05)。两组均无子宫破裂等严重并发症发生。结论:低浓度罗哌卡因复合小剂量舒芬太尼应用于VBAC安全有效,值得推广。Objective：To observe the feasibility of low concentration of ropivacaine combined with small dose of sufentanil used in intrathecal labor analgesia in vaginal birth after cesarean （ VBAC） . Methods：A retrospective study was conducted,which include all 83 cases of full-term VBAC parturients from Jan. 2012 to Dec. 2013. All the parturients were divided into two groups,labor analgesia group 37 cases and non-analgesia group 46 cases. The labor time, usage of oxytocin,the mode of delivery,postpartum hemorrhage,birth weight and Apgar scores were recorded respectively. Results：There was no significant difference in maternal age, BMI index,gestational age between two groups （P〉0. 05）. The usage of oxytocin in analgesia group （62. 2%） was significantly higher than the non-analgesia group （21. 7%）,（P〈0. 01）. There was no significant difference in labor time, postpartum hemorrhage, birth weight and Apgar scores between two groups（P〉0. 05）. The VAS scores were significantly lower after analgesia [（9. 43±0. 50）points vs （3. 16±0. 69）points,P〈0. 01）]. There were no severe complications such as uterine rupture in each group. Conclusion：Low concentration of ropivacaine combined with a small dose of sufentanil used in VBAC is safe and effective,it is worth promoting.

关 键 词：剖宫产术后阴道分娩 分娩镇痛 罗哌卡因 舒芬太尼 

分 类 号：R614[医药卫生—麻醉学]