舒芬太尼复合罗哌卡因与芬太尼复合罗哌卡因在分娩镇痛临床应用中的比较  

Comparison of Sufentanil combined with ropivacaine and fentanyl combined with ropivacaine in clinical application of labor analgesia

作　　者：杨家道 谭燕萍 秦用华 巫琴芬 

机构地区：[1]贵港市妇幼保健院手麻科,广西贵港537100 [2]贵港市妇幼保健院妇产科,广西贵港537100

出　　处：《中国现代医学杂志》2015年第10期102-105,共4页China Journal of Modern Medicine

摘　　要：目的 比较舒芬太尼复合罗哌卡因与芬太尼复合罗哌卡因在分娩镇痛中的效果。方法 选择该院2012年1月-2013年1月妇产科ASAΙ~Ⅱ级足月妊娠初产妇80例,随机分为舒芬太尼复合罗哌卡因组（A组,n=40）及芬太尼复合罗哌卡因（B组,n=40）。A组泵注药物为0.5μg/ml的舒芬太尼＋0.09%罗哌卡因100ml,B组泵注药物为2.5μg/ml的芬太尼＋0.09%罗哌卡因100ml。观察各组麻醉给药诱导前（T0）、给药后10（T1）、30（T2）、60（T3）、120（T4）和180 min（T5）时平均动脉压MAP、心率（HR）及VAS评分的变化,统计其产程、分娩方式及出生后1和5 min新生儿Apgar评分,同时记录其并发症。结果 试验前两组产妇的平均动脉压MAP及心率HR差异均无统计学意义（均P〉0.05）。A、B组VAS评分降低,两组间在给药后10、30、60、120和180 min,差异有统计学意义（P〈0.05）。两组产妇的产程间差异无统计学意义;A组1例、B组3例使用吸引器辅助分娩,两组无剖宫产者,比较两组产妇并发症发生率,A组心动过缓、呼吸抑制比例均低于B组（P〈0.01）。结论 舒芬太尼复合罗哌卡因和芬太尼复合罗哌卡因在分娩镇痛中的镇痛效果明显,起效快、镇痛强、对母婴无不良影响等优点,可安全用于分娩镇痛。[Objective] To compare the effect between Sufentanil combined with ropivacaine and fentanyl combined with ropivacaine in the clinical application of labor analgesia. [ Methods ] Eighty cases of term pregnancy with ASA of Ⅰ -Ⅱ level were Chosen from January 2012 to January 2013 in our department of gynaecology and obstetrics, and were randomly divided into two groups： Sufentanil combined with ropivacaine group （group A, n = 40） and fentanyl combined with ropivacaine group（group B, n = 40）. Group A was pumped the injection drug for 0.5 μg/ ml of sufentanil ＋ 0.09% ropivaeaine of 100 ml, group B was pumped the injection drug for 2.5 μg/ml of fentanyl ＋ 0.09% ropivacaine of 100 ml, with no-analgesic drugs. The changes of mean arterial pressure （MAP）, heart rate （HR） and VAS score before anesthetic drug induction （T0）, 10 min （T1）, 30 rain （T2） and 60 min （T3）, 120 min （T4）, 180 min （T5） after drug use were observed. Stage of labor, delivery mode and neonatal Apgar score after born for 1, 5 rain were counted statistically, the complications were recorded at the same time, and both effects of labor analgesia were evaluated. [Results] The MAP and HR in group A, B during analgesia had no statistically significant difference compared with those before analgesia （P 〉 0.05）. VAS scores of A, B two groups were reduced, and the difference in VAS score between the two groups in 10 min, 30 min, 60 min, 120 min, 180 min after injecting drug was statistically significant （P 〈 0.05）. There was no statistically significant difference in the stage of labor between two groups. Suction units were used in 1 case of group A and 3 cases of group B for assisting childbirth. Cesarean section was not applied in wo groups. Incidence of complication in two groups was compared. The ratio of bradycardia, respiratory inhibition in group A was lower than in group B （P 〈 0.01）. [Conclusions] Sufentanil combined with ropivacaine has an apparent analgesic effect which is better th

关 键 词：舒芬太尼复合罗哌卡因 芬太尼复合罗哌卡因 分娩镇痛 并发症 

分 类 号：R614.3[医药卫生—麻醉学] R714.3[医药卫生—外科学]