单纯舒芬太尼与舒芬太尼联合罗哌卡因蛛网膜下腔注射用于分娩镇痛效果的对比研究  

Comparison of the efficacy of intrathecal injection of sufentanil and sufentanil in combination with ropivacaine for labor analgesia

作　　者：靳浩 傅春花 黄文忠 JIN Hao;FU Chunhua;HUANG Wenzhong(Department of Anesthesiology,Yubei District People s Hospital,Chongqing 401120,China)

机构地区：[1]重庆市渝北区人民医院麻醉科,重庆401120

出　　处：《麻醉安全与质控》2020年第6期345-348,共4页Perioperative Safety and Quality Assurance

摘　　要：目的探讨单纯舒芬太尼与舒芬太尼联合罗哌卡因蛛网膜下腔注射用于分娩镇痛效果。方法选取我院产科2016~2018年收治的90例分娩产妇,根据随机数字表法分为A、 B、 C 3组,每组30例。A组蛛网膜下腔注射舒芬太尼联合硬膜外镇痛, B组蛛网膜下腔注射舒芬太尼和罗哌卡因联合硬膜外镇痛, C组单纯硬膜外镇痛。观察比较3组产妇镇痛效果、下肢肌力、瘙痒发生率、产程情况、新生儿Apgar评分、产妇满意度。结果 A、 B组麻醉起效时间差异无统计学意义(P>0.05),且均快于C组(P<0.05)。A、 B组麻醉后30 min的VAS评分差异无统计学意义(P>0.05),均低于C组(P<0.05), 3组在分娩时VAS评分差异无统计学意义(P>0.05)。B组麻醉后30 min的Lovett分级低于A、 C组(P<0.05)。C组瘙痒发生率低于A、 B组(P<0.05)。A组产妇满意度高于B、 C组(P<0.05)。三组总产程时间及新生儿Apgar评分差异均无统计学意义(P>0.05)。结论蛛网膜下腔单纯注射舒芬太尼可以实现快速有效的分娩镇痛,对肌力和循环影响小,产妇满意度高,且对母婴安全没有明显影响。Objective To investigate the efficacy of intrathecal injection of sufentanil and sufentanil in combination with ropivacaine for labor analgesia.Methods Altogether 90 cases of parturient women in our hospital from 2016 to 2018 were selected and divided into three groups according to the random number table method,each with 30 cases.Group A received intrathecal injection of sufentanil combined with epidural analgesia,group B received intrathecal injection of sufentanil and ropivacaine combined with epidural analgesia,and group C received simple epidural analgesia.The analgesic effect,muscle strength of lower limbs,incidence of pruritus,labor process,Apgar score and maternal satisfaction were compared among three groups.Results The anesthesia onset time of group A and group B had no significant difference(P>0.05),and both of them were faster than that of group C(P<0.05).VAS scores of group A and group B at 30 min after anesthesia showed no significant difference(P>0.05),and was lower than that of group C(P<0.05).VAS score at delivery had no significant difference among three groups(P>0.05).Lovett grade of group B was lower than that of group A and group C at 30 min after anesthesia(P<0.05).The incidence of pruritus in group C was lower than that in group A and B(P<0.05).Maternal satisfaction in group A was higher than that in group B and group C(P<0.05).The total labor time and Apgar score had no significant difference among three groups(P>0.05).Conclusion Intrathecal injection of sufentanil alone can achieve rapid and effective labor analgesia,with high maternal satisfaction and little impact on muscle strength and circulative function,which has no significant effect on maternal and child safety.

关 键 词：舒芬太尼 罗哌卡因 蛛网膜下腔注射 分娩镇痛 

分 类 号：R614[医药卫生—麻醉学]