罗哌卡因椎管内麻醉复合舒芬太尼在初产妇分娩镇痛中的应用  

Application of Ropivacaine Infiltration Anesthesia Combined with Sufentanil in Labor Analgesia of Primipara

作　　者：张剑波 苏然 ZHANG Jianbo;SU Ran(Guangzhou General Hospital of Guangzhou Military Region,Guangdong Guangzhou 510515,China)

机构地区：[1]广州军区广州总医院,广东广州510515

出　　处：《河北医学》2020年第10期1677-1682,共6页Hebei Medicine

基　　金：广东省医学科研基金立项课题,(编号:A20184878)。

摘　　要：目的:探究罗哌卡因椎管内麻醉复合舒芬太尼在初产妇分娩镇痛当中的应用。方法:选取2016年12月到2018年7月在我院进行分娩的初产妇100例,随机分为对照组和复合组,每组50例初产妇,对照组产妇进行罗哌卡因椎管内麻醉,复合组患者进行罗哌卡因椎管内麻醉复合舒芬太尼。对两组产妇的麻醉指标,产程时间,麻醉前和麻醉后5min、30min、60min和90min的视觉模拟评分(VAS)评分比较,分娩方式比较以及产妇的不良反应发生率。结果:复合组产妇的镇痛起效时间(7.13±1.97)min、完全阻滞时间(12.59±2.34)min明显短于对照组(16.45±2.14)min、(24.56±2.81)min,镇痛持续时间(153.43±26.57)min明显长于对照组(106.35±31.27)min;复合组产妇的第一产程时间(414.75±176.73)min、第二产程时间(32.12±8.56)min和第三产程时间(6.71±1.47)min均短于对照组(532.26±207.34)min、(46.86±10.47)min、(10.13±2.69)min;麻醉后,两组产妇的疼痛状况都有多缓解,但是复合组产妇麻醉后5min、30min、60min和90min的疼痛程度(3.68±0.41)分、(2.56±0.33)分、(1.64±0.22)分、(1.57±0.21)分明显低于对照组(4.76±0.49)分、(3.14±0.32)分、(2.58±0.24)分、(2.46±0.23)分;复合组产妇的自然分娩率86.00%明显高于对照组62.00%(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:罗哌卡因椎管内麻醉复合舒芬太尼对初产妇分娩镇痛的效果较好,可以快速起效,缩短完全阻滞时间,延长镇痛持续时间,缩短第一产程时间、第二产程时间和第三产程时间,减轻产妇的疼痛程度,提高自然分娩率。Objective:To explore the application of ropivacaine intraspinal anesthesia combined with sufentanil in labor analgesia of primipara.Methods:100 cases of primipara who delivered in our hospital were selected as the research object.The selected time range was from December 2016 to July 2018.They were divided into control group or compound group,50 cases of primipara in each group.The control group was given ropivacaine intraspinal anesthesia,and the compound group was given ropivacaine intraspinal anesthesia combined with sufentanil.Anesthesia index,duration of labor,visual analogue scale(VAS)scores of 5,30,60 and 90 minutes before and after anesthesia,delivery mode and incidence of adverse reactions were compared between the two groups.Results:The onset time of analgesia(7.13±1.97)min,complete block time(12.59±2.34)min and duration of analgesia(153.43±26.57)min in the compound group were significantly shorter than those in the control group(16.45±2.14)min,24.56±2.81)min and(106.35±31.27)min respectively The time of the third stage of labor(6.71±1.47)min was shorter than that of the control group(532.26±207.34)min,(46.86±10.47)min,(10.13±2.69)min;after anesthesia,the pain of the two groups of parturients was more relieved,but the pain degree of the compound group of parturients was(3.68±0.41),(2.56±0.33),(1.64±0.22),(1.57±0.21)respectively.It was significantly lower than that of the control group(4.76±0.49),(3.14±0.32),(2.58±0.24),(2.46±0.23);the natural delivery rate of 86.00%in the compond group was significantly higher than that of 62.00%in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The effect of ropivacaine combined with sufentanil on labor analgesia of primipara is better.It can take effect quickly,shorten the time of complete block,prolong the duration of analgesia,shorten the time of the first labor process,the second labor process and the third labor process,reduce the degree of pain of primi

关 键 词：罗哌卡因椎管内麻醉 舒芬太尼 初产妇分娩镇痛 应用效果 

分 类 号：R714.3[医药卫生—妇产科学]