罗哌卡因复合舒芬太尼用于产妇自控硬膜外分娩镇痛的效果及对血浆催乳素的影响  

Curative effect of ropivacaine combined with sulfentanyl on patient controlled epidural analgesia for puerperants and its influence on plasma prolactin

作　　者：陈健 陈清娟 郑丹 蔡璐 陈宏才 

机构地区：[1]浙江台州恩泽医疗中心(集团)台州医院附属妇产医院麻醉科,浙江台州318000 [2]浙江台州恩泽医疗中心(集团)台州医院附属妇产医院妇产科,浙江台州318000 [3]浙江台州恩泽医疗中心(集团)路桥医院麻醉科,浙江台州318050

出　　处：《中国性科学》2017年第2期102-104,共3页Chinese Journal of Human Sexuality

基　　金：浙江省台州市科技计划项目(1301ky51)

摘　　要：目的:探讨罗哌卡因复合舒芬太尼用于产妇自控硬膜外分娩镇痛的效果及对血浆泌乳素的影响。方法:选择在我院分娩的产妇80例,随机分为观察组和对照组。两组产妇均为足月初产妇,观察组产妇接受罗哌卡因复合舒芬太尼自控硬膜外分娩镇痛,对照组产妇拒绝接受分娩镇痛。观察并比较两组产妇第一产程(T_1),第二产程(T_2)、第三产程(T_3)时的疼痛情况,同时观察产妇的最终分娩方式及不良反应,并在产前及产后48h检测血浆催乳素浓度,探讨自控镇痛对血浆泌乳素分泌的影响。结果:观察组各产程VAS评分均低于对照组(P<0.05);产后48h,两组产妇血浆催乳素浓度均较产前升高(P<0.05),且观察组升高幅度大于对照组(P<0.05);观察组阴道分娩例数多于对照组(P<0.05);两组不良反应发生率比较无统计学差异(P>0.05)。结论:罗哌卡因复合舒芬太尼硬膜外自控镇痛能有效缓解产妇各产程的疼痛,减少分娩疼痛对于血浆催乳素的影响,减少阴道助产及剖宫产的发生,不良反应少,是一种安全有效的分娩镇痛方式。Objectives： To discuss curative effect of ropivacaine combined with sulfentanyl on patient controlled epidural analgesia for puerperae and its influence on plasma prolactin （PRL）. Methods： 80 puerperae were selected and divided into observation group and control group randomly. The puerperae in two groups were all full - term primiparae, and the primiparae in observation group were given Ropivacaine combined with Sulfentanyl for patient controlled epidural analgesia, while primiparae in control group refused to accept labor analgesia. The pain intensity of two groups were observed and compared in the first stage （ T1 ） , second stage （ T2 ） and third stage （ T3 ）. Meantime, the final delivery way and untoward effect were observed. The plasma PRL concentration before and 48 hours after delivery were detected, and the influence of patient controlled epidural analgesia on the secretion of plasma PRL was discussed as well. Results ： The VAS of patients in observation group were lower than those in control group （ P 〈 0. 05 ）. The plasma PRL concentration of patients 48 hours after delivery in two groups all increased （ P 〈 0. 05 or P 〈 0. 01 ） , and the rising rate of patients in observation group was higher than that in control group （ P 〈 0. 05 ）. The vaginal delivery rate of patients in observation group was higher than that in control group （P 〈0. 05）. After comparing the occurrence rates of untoward effect, no statistical differences appeared （P 〉 0. 05）. Conclusion： The application of Ropivacaine combined with Sulfentanyl on patient controlled epidural analgesia can effectively release pain of all birth processes, and reduce the influence on plasma PRL and occurrences of vaginal midwifery and C - sect with little untoward effect, which is a safe and effective way of labor analgesia.

关 键 词：罗哌卡因 舒芬太尼 自控硬膜外分娩镇痛 血浆催乳素 

分 类 号：R714.3[医药卫生—妇产科学]